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      Management of subclinical hypothyroidism in pregnancy: are we too simplistic?

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          Abstract

          Guideline advice of many societies on the management of subclinical hypothyroidism in pregnancy suggests treatment when TSH serum levels exceed 2.5 mU/l. Justification of this procedure is based on limited experience, mainly from studies carried out in patients with positive thyroid-specific antibodies and higher TSH levels that classically define the condition in the non-pregnant state. Taking into account a lack of clear understanding of the regulation of thyroid hormone transport through the utero-placental unit and in the absence of foetal markers to monitor the adequacy of thyroxine treatment, this review attempts to discuss currently available data and suggests a more cautious approach.

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          Author and article information

          Journal
          Eur. J. Endocrinol.
          European journal of endocrinology
          BioScientifica
          1479-683X
          0804-4643
          Jul 2015
          : 173
          : 1
          Affiliations
          [1 ] Experimental and Clinical EndocrinologyUniversity of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, GermanyDepartment of EndocrinologyUniversity of Manchester, Manchester, UKDepartment of Internal MedicineRotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The NetherlandsDepartment of Obstetrics and GynaecologyNational University of Singapore, Singapore, SingaporeInstituto de Investigaciones BiomedicasConsejo Superior de Investigaciones Cientificas and Universidad Autonoma de Madrid, Madrid, SpainCenter for Biomedical Research on Rare DiseasesMadrid, SpainPierre et Marie Curie UniversityParis, FranceDepartment of Clinical Medicine and SurgeryUniversity of Naples 'Federico II', Naples 80131, ItalyCollege of Medical and Dental SciencesInstitute for Biomedical Research, Centre for Endocrinology, Diabetes and Metabolism, Level 2, University of Birmingham, Birmingham B15 2TT, UKDepartment of EndocrinologyInstitute of Clinical Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark Experimental and Clinical EndocrinologyUniversity of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, GermanyDepartment of EndocrinologyUniversity of Manchester, Manchester, UKDepartment of Internal MedicineRotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The NetherlandsDepartment of Obstetrics and GynaecologyNational University of Singapore, Singapore, SingaporeInstituto de Investigaciones BiomedicasConsejo Superior de Investigaciones Cientificas and Universidad Autonoma de Madrid, Madrid, SpainCenter for Biomedical Research on Rare DiseasesMadrid, SpainPierre et Marie Curie UniversityParis, FranceDepartment of Clinical Medicine and SurgeryUniversity of Naples 'Federico II', Naples 80131, ItalyCollege of Medical and Dental SciencesInstitute for Biomedical Research, Centre for Endocrinology, Diabetes and Metabolism, Level 2, University of Birmingham, Birmingham B15 2TT, UKDepartment of EndocrinologyInstitute of Clinical Medicine, Aalborg University Hos
          [2 ] Experimental and Clinical EndocrinologyUniversity of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, GermanyDepartment of EndocrinologyUniversity of Manchester, Manchester, UKDepartment of Internal MedicineRotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The NetherlandsDepartment of Obstetrics and GynaecologyNational University of Singapore, Singapore, SingaporeInstituto de Investigaciones BiomedicasConsejo Superior de Investigaciones Cientificas and Universidad Autonoma de Madrid, Madrid, SpainCenter for Biomedical Research on Rare DiseasesMadrid, SpainPierre et Marie Curie UniversityParis, FranceDepartment of Clinical Medicine and SurgeryUniversity of Naples 'Federico II', Naples 80131, ItalyCollege of Medical and Dental SciencesInstitute for Biomedical Research, Centre for Endocrinology, Diabetes and Metabolism, Level 2, University of Birmingham, Birmingham B15 2TT, UKDepartment of EndocrinologyInstitute of Clinical Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark.
          Article
          EJE-14-1005
          10.1530/EJE-14-1005
          25650404

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