15
Î The impact of pregnancy on women with newly diagnosed medullary
carcinoma or anaplastic cancer is unknown. However, a delay in
treatment is likely to adversely impact outcome. Therefore, surgery
should be strongly considered, following assessment of all clinical
factors. (S-L)
Î Pregnant women with thyroid cancer should be managed at the same
TSH goal as determined pre-conception. TSH should be monitored
approximately every 4 weeks until 16–20 weeks of gestation, and at
least once between 26–32 weeks of gestation. (S-M)
Î Pregnancy should be deferred for 6 months after a woman has
received therapeutic radioactive iodine (
131
I) treatment. (S-L)
Î Ultrasound and thyroglobulin monitoring during pregnancy is not
required in women with a history of previously treated differentiated
thyroid carcinoma with undetectable serum thyroglobulin levels (in the
absence of Tg autoantibodies) classified as having no biochemical or
structural evidence of disease prior to pregnancy. (S-M)
Î Ultrasound and thyroglobulin monitoring should be performed during
pregnancy in women diagnosed with well-differentiated thyroid cancer
and a biochemically or structurally incomplete response to therapy, or
in patients known to have active recurrent or residual disease. (S-M)
Î Ultrasound monitoring of the maternal thyroid should be performed
each trimester during pregnancy in women diagnosed with papillary
thyroid microcarcinoma (PTMC) who are under active surveillance.
(W-L)
