Full-pregnancy-cycle management for women of childbearing age with differentiated thyroid cancer
10.7659/j.issn.1005-6947.2024.11.002
- VernacularTitle:育龄女性分化型甲状腺癌患者的妊娠全周期管理
- Author:
Rili GAO
1
;
Haixia GUAN
1
Author Information
1. 南方医科大学附属广东省人民医院(广东省医学科学院) 内分泌科,广东广州 510080
- Publication Type:Journal Article
- Keywords:
Thyroid Neoplasms;
Pregnancy;
Disease Management
- From:
Chinese Journal of General Surgery
2024;33(11):1759-1765
- CountryChina
- Language:Chinese
-
Abstract:
With the rising incidence of thyroid cancer,the number of women of childbearing age diagnosed with differentiated thyroid cancer (DTC) in China has significantly increased. Many in this group bear the responsibility of reproduction,which necessitates higher standards for the clinical management of DTC. Therefore,implementing full-pregnancy-cycle management (encompassing preconception,pregnancy,and postpartum phases) for women of childbearing age with DTC represents a new model of cancer health management tailored to China's national conditions and contemporary characteristics. This approach is of great significance in safeguarding the perinatal and long-term health of mothers and offspring,improving the standardization of DTC management,and enhancing patients' quality of life. Based on existing literature and guidelines,the authors outline specific practices for implementing full-pregnancy-cycle management,spanning the preconception,pregnancy,and postpartum phases. During the preconception phase,unnecessary delays in conception should be avoided,individualized treatment plans for DTC should be developed in alignment with reproductive goals,and thorough pre-pregnancy counseling should be provided. In the pregnancy phase,the focus is on continuing thyrotropin (TSH) suppressive therapy,guiding appropriate thyroid hormone medication use during pregnancy,and monitoring and following up on thyroid function and DTC progression. In the postpartum phase,it is essential to understand the safety of TSH suppressive therapy during lactation,monitor for the occurrence of postpartum thyroiditis,and address its impact on thyroid hormone therapy. It is hoped that this field will garner greater attention from multidisciplinary scholars,fostering collaboration to accumulate data,conduct long-term follow-up,and optimize specific strategies and pathways for full-pregnancy-cycle management,thereby promptly ensuring the best medical services to the target population.
