Does anyone here disagree with universal screening for thyroid disorder in pregnancy?
I really have only two problems:
How do you treat those who are found to have minor thyroid disturbances?
The screening should include pre-conception screening, at least to the point of making it readily available and publicising it. If nothing else, it might help to identify the changes that have occurred later, in pregnancy.
Womens Health (Lond Engl). 2015 Jun;11(3):295-307.
Should all women be screened for thyroid dysfunction in pregnancy?
Taylor PN1, Okosieme OE1, Premawardhana L1, Lazarus JH1.
• 1Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
The subject of universal thyroid screening in pregnancy generates impassioned debate. Thyroid dysfunction is common, has significant adverse implications for fetal and maternal well-being, is readily detectable and can be effectively and inexpensively treated. Furthermore, the currently recommended case-finding strategy does not identify a substantially proportion of women with thyroid dysfunction thus favoring universal screening. On the other hand subclinical thyroid dysfunction forms the bulk of gestational thyroid disorders and the paucity of high-level evidence to support correction of these asymptomatic biochemical abnormalities weighs against universal screening. This review critically appraises the literature, examines the pros and cons of universal thyroid screening in pregnancy, highlighting the now strong case for implementing universal screening and explores strategies for its implementation.
child neurodevelopment; hyperthyroidism; hypothyroidism; isolated hypothyroxinemia; levothyroxine; pregnancy; screening; subclinical hypothyroidism
PMID: 26102469 [PubMed - as supplied by publisher]