Palabras clave
Embarazo
Diagnóstico
Hormonas Tiroideas
Tirotropina
Terapéutica
Cómo citar
Resumen
Contexto: el hipotiroidismo gestacional se asocia a complicaciones del embarazo y retrasos en el desarrollo del feto.
Objetivo: describir las pautas diagnósticas y terapéuticas del hipotiroidismo gestacional.
Materiales y métodos: se realizó una exploración de la literatura científica en diversas bases de datos electrónicas (Medline, Ebsco, Embase y demás), con la ayuda de términos de búsqueda libres y estandarizados. Se valoró la adecuación de la certeza por publicación y para el sostén de la evidencia, la cual fue resumida de forma narrativa. Se incluyeron 88 artículos.
Resultados: el hipotiroidismo es el más frecuente desorden de la tiroides en el embarazo y se asocia con resultados gestacionales adversos y deterioro cerebral del feto. En la gestación, las pruebas de laboratorio de la función tiroidea (tiroxina, triyodotironina, hormona estimulante de la tiroides (TSH)) deben ser interpretadas con relación a la edad gestacional. La existencia de anticuerpos antitiroideos confirma el diagnóstico de afección autoinmune de la tiroides. Las gestantes con hipotiroidismo clínico se tratan con levotiroxina, con la respectiva monitorización, para sostener la TSH en el nivel definido del trimestre y evitar un tratamiento excesivo o insuficiente.
Conclusiones: el hipotiroidismo gestacional es una patología potencialmente peligrosa para el binomio madre-hijo, siendo fácilmente diagnosticada. En la actualidad se cuenta con una terapéutica efectiva y segura, lo cual requiere de la toma de decisiones consensuadas, con el propósito de considerar los riesgos y beneficios de la terapéutica instaurada, tanto para la gestante como para el feto.
Citas
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