Información del artículo
Pregnancy induces complex hormonal and immunological changes that modify normal thyroid physiology. Therefore, evaluation of thyroid function during pregnancy should be interpreted according to these changes. In our opinion, the high prevalence of pregnancy-related thyroid disorders and their important consequences for both mother and fetus indicate the need for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is diagnosed, the management of the disorder requires frequent monitoring to adjust treatment accurately. The goal of treating hyperthyroidism with thionamide drugs is to maintain serum thyroxin (T4) in the upper normal range (free T4, 2-2.5ng/dl; total T4, 12.0-18.0μg/dl) using the lowest possible dose of the drug, while in hypothyroidism the goal is to return serum thyrotropin to the range between 0.5 and 2.5mU/l.
Key words:
Pregnancy
Hyperthyroidism
Hypothyroidism
Postpartum
Management
El embarazo comporta una serie de cambios hormonales e inmunológicos que dan lugar a modificaciones en la fisiología normal del tiroides. Por tanto, la evaluación de la función tiroidea durante el embarazo debe interpretarse teniendo en cuenta estos cambios. En nuestra opinión, la gran prevalencia de trastornos tiroideos asociados al embarazo y las graves consecuencias que pueden causar a la madre y el feto apoyan la necesidad de realizar pruebas de cribado de disfunción tiroidea de manera sistemática, tanto antes como durante el embarazo. Una vez se ha diagnosticado una disfunción tiroidea será necesario realizar una monitorización frecuente para ajustar el tratamiento de forma precisa. El objetivo del tratamiento del hipertiroidismo con fármacos antitiroideos es lograr que la concentración de tiroxina sérica (T4) se mantenga en el límite alto del rango normal (T4 libre, 2-2,5ng/dl; T4 total, 12-18μg/dl) con la mínima dosis posible, mientras que, en el caso del hipotiroidismo, el objetivo es conseguir que la concentración de tirotropina se mantenga entre 0,5 y 2,5mU/l.
Palabras clave:
Embarazo
Hipertiroidismo
Hipotiroidismo
Posparto
Manejo
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