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Here are some key points of the interim management guidelines and research agenda put forth by the American Thyroid Association. The full statement is scheduled to be posted this month at www.thyroid.org.
* Physicians should optimize the treatment of women with overt hypothyroidism before they conceive and monitor their thyroxine levels through the pregnancy.
Because a surge in thyroxine production usually occurs at about week 8 in gestation, women on thyroxine should be counseled to increase their intake 30%-50% when they become pregnant.
* Physicians should screen women who are at risk for thyroid disease before they become pregnant and shortly after they conceive.
Risk factors include personal or family history of thyroid disease, thyroid autoimmunity, type 1 diabetes, or other autoimmune disorders, including rheumatoid arthritis and systemic lupus erythematosus.
* Women with subclinical hypothyroidism should have their thyroid status monitored during pregnancy.
* Physicians should counsel women about adequate iodine intake during pregnancy and lactation.
Source: HighBeam Research, Statement on early maternal thyroidal insufficiency.(Obstetrics)