Clinical guidelines for management of thyroid nodule and cancer during pregnancy
Galofré JC (1), Riesco-Eizaguirre G (2), Alvarez-Escolá C (2)
Grupo de Trabajo de Cáncer de Tiroides de la Sociedad Española de Endocrinología y Nutrición.
(1) Departamento de Endocrinología, Clínica Universidad de Navarra, Pamplona, España.
(2) Servicio de Endocrinología, Hospital Universitario La Paz, Madrid, España.
Magazine: Endocrinología y Nutrición
Date: Mar 1, 2014Thyroid Disease Area Endocrinology and Nutrition [SP]
Special considerations are warranted in management of thyroid nodule and thyroid cancer during pregnancy. The diagnostic and therapeutic approach of thyroid nodules follows the standard practice in non-pregnant women.
On the other hand, differentiated thyroid cancer management during pregnancy poses a number of challenges for the mother and fetus.
The available data show that pregnancy is not a risk factor for thyroid cancer development or recurrence, although flare-ups cannot be completely ruled out in women with active disease. If surgery is needed, it should be performed during the second term or, preferably, after delivery.
A majority of pregnant patients with low-risk disease only need adjustment in levothyroxine therapy. However, women with increased serum thyroglobulin levels before pregnancy or structural disease require regular thyroglobulin measurements and neck ultrasound throughout pregnancy. Pregnancy is an absolute contraindication for radioactive iodine administration.
CITATION Endocrinol Nutr. 2014 Mar;61(3):130-8. doi: 10.1016/j.endonu.2013.08.003. Epub 2013 Oct 28.
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