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Management of thyroid nodules during pregnancy
C M Doherty1, M L Shindo, D H Rice
1Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
The Laryngoscope
|March 1, 1995
Summary
Established guidelines are lacking for managing thyroid nodules during pregnancy. This study suggests specific criteria for fine-needle aspiration and biopsy, finding a 39% malignancy rate without adverse fetal outcomes.
Area of Science:
- Endocrinology
- Obstetrics
- Oncology
Background:
- Thyroid nodules are common, and their management during pregnancy lacks established guidelines.
- Pregnancy can alter thyroid physiology, potentially affecting nodule behavior and diagnostic approaches.
Purpose of the Study:
- To review the management and outcomes of thyroid nodules detected during pregnancy.
- To propose recommendations for the diagnostic work-up of pregnant patients with thyroid nodules.
Main Methods:
- Retrospective review of 23 pregnant patients with newly discovered thyroid nodules.
- Classification of patients based on management: work-up during pregnancy, biopsy post-delivery, or observation.
- Analysis of malignancy incidence, surgical interventions, and fetal outcomes.
Main Results:
- A 39% incidence of malignancy was observed among the studied thyroid nodules.
- No fetal morbidity or mortality was reported in relation to nodule management or intervention.
- Specific criteria were identified for performing fine-needle aspiration (FNA) during pregnancy.
Conclusions:
- Fine-needle aspiration is recommended for pregnant patients with specific nodule characteristics before 20 weeks gestation.
- Nodule growth during thyroid hormone suppression therapy warrants consideration for biopsy later in gestation.
- Current management approaches appear safe for fetal outcomes, but further guidelines are needed.