Thyroid and parathyroid surgery in pregnancy

Owen, Randall P.; Chou, Katherine; Silver, Carl E.; Beilin, Yaakov; Tang, Jianbo; Yanagisawa, Robert; Rinaldo, Alessandra; Shaha, Ashok R.; Ferlito, Alfio

doi:10.1007/s00405-010-1390-0

Cited by 11 publications

(11 citation statements)

References 69 publications

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“…Noticeably, elevated levels of HCG are responsible for gestational thyrotoxicosis [18]. Primary hypothyroidism in pregnancy is most commonly resulted from Hashimoto’s thyroiditis [32]. In addition, other causes including thyroid ablation therapy and iodine deficiency are the most prevalent aetiologies [32].…”

Section: Discussionmentioning

confidence: 99%

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

et al. 2020

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Objectives: To explore trimester-specific thyroid function changes under different iodine statuses throughout pregnancy. Methods: A cross-sectional study was conducted to assess the pregnancy iodine status, and 2,378 healthy pregnant women covering all 3 trimesters were recruited. Urinary iodine concentration (UIC) was measured by collecting spot urine samples. Blood samples were collected to evaluate thyroid function. Thyroid B-ultrasonography was conducted to measure the thyroid volume (Tvol). Results: The median UIC was 168 μg/L (111-263 μg/L). The UIC, free triiodothyronine (FT3), and free thyroxine (FT4) were significantly decreased as the pregnancy progressed (p < 0.001, p for trend <0.001), while Tvol increased (p < 0.001, p for trend <0.001). Thyrotropin (TSH) was significantly different between the 3 trimesters and showed an upward trend (p < 0.001), but the p for trend was not significant (p for trend = 0.88). After stratification by UIC, there were no significant differences in serum TSH, FT4, or FT3 level between UIC groups. Tvol was significantly higher in the UIC ≥500 μg/L group in the first trimester (β: 2.41, 95% CI: 1.09-3.72, p <0.001), as well as in the 250 ≤ UIC < 500 μg/L group (β: 1.65, 95% CI: 0.61-2.70, p < 0.001) and UIC ≥500 μg/L group (β: 3.35, 95% CI: 1.96-4.74, p < 0.001) in the third trimester. Conclusions: No difference was observed in TSH, FT3, or FT4 among the different iodine status groups throughout pregnancy. Tvol increased as the pregnancy progressed, and it was especially higher in the UIC ≥500 μg/L group in the first and third trimesters.

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Section: Discussionmentioning

confidence: 99%

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

et al. 2020

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“…As far as the opportunities for surgery are concerned, based on the evidence in the majority of the published studies, in which evolution was similar in DTC patients operated during pregnancy or after delivery, several authors (19)(20)(21) and the international guidelines of the American Thyroid Association (ATA) (22) propose surgery in the post-delivery period unless there are negative evolving risk factors, such as histological findings of differentiation, lymph node involvement, or rapid tumor growth. If surgery is decided upon, it may be performed in the second trimester, preferably in week 22.…”

Section: Discussionmentioning

confidence: 99%

Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Cabezón

Carrizo

Costanzo

2013

Arq Bras Endocrinol Metab

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Objective: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. Subjects and methods: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131 I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. Results: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease. Conclusions: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy. Arq Bras Endocrinol Metab. 2013;57(4):307-11

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“…Surgery should therefore be performed only when the advantages of therapy outweigh the higher risks. If necessary, the second trimester is the optimal time (Owen et al 2010;StagnaroGreen et al 2011). …”

Section: Thionamide Therapy and Pregnancymentioning

confidence: 97%

Thyroid Disorders

Gessl¹,

Lemmens‐Gruber²,

Kautzky‐Willer³

2012

Handbook of Experimental Pharmacology

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All forms of thyroid diseases are much more frequently observed in women than men, although the reasons are still not completely elucidated.Hyperthyroidism is defined by elevated circulating free thyroid hormones. The prevalence is about 2 % in women and 0.2 % in men. The most frequent causes are various forms of thyroid autonomy in elderly women and Graves' disease, which occurs mostly in younger women.Hypothyroidism is defined by a lack of thyroid hormones. It is a common endocrine disorder caused by autoimmune thyroiditis (Hashimoto thyroiditis), iodine deficiency or following surgery or radioiodine therapy. Thyroxine requirements depend on fat-free mass and are, therefore, somewhat higher in males who are more often undersubstituted. In pregnancy lower TSH-reference ranges have to be considered and thyroid function should be monitored throughout pregnancy to avoid harm to the foetus caused by maternal thyroid dysfunctions. If overtreated women more often feature fractures, whereas males more often develop atrial fibrillation.

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Thyroid and parathyroid surgery in pregnancy

Cited by 11 publications

References 69 publications

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Thyroid Disorders

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