Abstract
Thyroid hormones are crucial for the growth and differentiation of embryonic tissues. Maternal thyroxine is essential for fetal development and for incident-free pregnancy course.
There is still a controversy among different scientific societies in relation to the recommendations on whether universal or case finding screening for the detection of thyroid dysfunction during gestation should be performed, and what laboratory test system should be chosen. There is a general agreement about the need for treatment of clinical hypothyroidism and/or clinical hyperthyroidism during pregnancy.
Various studies have shown also an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems. The diagnosis of subclinical forms of thyroid diseases without laboratory test is not possible.
Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester, and assessment of thyroid antibodies should be included, as the positive results points out the women at risk. Because thyroid dysfunction is a common, easily diagnosed and effectively treated disorder without special risk, an early evaluation (before week 10) TSH, TPO ab and eventually FT4 and Tgab in all pregnant women is recommendable.
Adequate iodine nutrition is important before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus. Two cases showing the importance of careful case history, somatic and laboratory examination in pregnant women are enclosed.