Gebelik Öncesi, Gebelik ve Postpartum Dönemde Tiroid Nodülleri Ve Tiroid Kanserine Yaklaşım
Synopsis
Thyroid nodules and thyroid cancer require specific diagnostic, surveillance, and therapeutic approaches in women of reproductive age during the preconception, pregnancy, and postpartum periods. This chapter provides a comprehensive overview of their contemporary management, emphasizing risk-based assessment and multidisciplinary decision-making. The roles of clinical evaluation, serum thyroid-stimulating hormone (TSH) measurement, ultrasonography, and fine-needle aspiration biopsy in thyroid nodule assessment are discussed. Management strategies for benign and indeterminate nodules, differentiated thyroid cancer, medullary thyroid cancer, and advanced thyroid malignancies are addressed. Particular attention is given to the timing of thyroid surgery during pregnancy, levothyroxine therapy, risk-adapted TSH targets, and the contraindications associated with radioactive iodine administration. Preconception counseling, fertility considerations, postpartum reassessment, and the management of thyroid surgery and radioactive iodine treatment during lactation are also reviewed. By integrating current evidence and clinical recommendations, this chapter highlights individualized management strategies aimed at optimizing maternal and fetal safety while maintaining favorable oncological outcomes throughout the preconception, pregnancy, and postpartum periods.
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