Review Article
Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease
Table 2
What to do in clinical practice concerning thyroid function tests in pregnancy, when diagnosing hypo- or hyperthyroidism, respectively?
| | (i) Hypothyroidism: |
| | (a) Serum TSH, evaluation respecting the gestation-induced suppression | | (b) Measurement of antithyroperoxidase antibodies | | (c) Sometimes measurement of TSH receptor antibodies and/or thyroglobulin antibodies | | (d) Free T4 estimate | | (1) “Direct measurement” with difficulty of interpretation | | (2) Measurement of total T4 and T3 uptake test—more reliable | | (3) Measurement of total T4 and correcting by 50% increase for pregnancy/TBG effect |
| | (ii) Hyperthyroidism: |
| | (a) Serum TSH, evaluation respecting the gestation-induced suppression | | (b) Measurement of TSH receptor antibodies | | (c) Free T4 estimate/free T3 estimate | | (1) “Direct measurement” with difficulty of interpretation | | (2) Measurement of total T4/T3 and T3 uptake test—more reliable | | (3) Measurement of total T4/T3 and correcting the nonpregnant reference range by 50% increase for pregnancy/TBG effect |
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Adapted from: [10].
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