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Thyroid Disease in Preconception, Pregnancy, and Postpartum

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Physiology, Laboratory Testing, and Iodine 8 Recommendations Table 2. Indications for Thyroid Function Testing Pregnancy Strength * Level # All newly pregnant women should undergo clinical evaluation and assessment for risk factors a for thyroid dysfunction in pregnancy. Good Practice Statement In women without known thyroid disease, it is suggested that TSH testing be offered upon a positive pregnancy test to those at increased risk of thyroid dysfunction during pregnancy. a Conditional Moderate In women treated with levothyroxine, TSH testing may be performed upon pregnancy confirmation, approximately every 4 weeks during the first half of pregnancy, at least once in the third trimester, and 4–6 weeks aer any dose adjustment. Conditional Moderate Postpartum Strength * Level # Apply the same thyroid function testing indications to postpartum women as those for the general non-pregnant population. Specifically for women using levothyroxine, thyroid function testing should be performed around 6 weeks postpartum or following any levothyroxine dose adjustment. Good Practice Statement For recommendations preconception (including fertility treatments), see Dysfunction and Infertility. a As defined in Table 1. * Strength of Recommendation; # Level of Evidence; Good Practice Statement.

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