MANAGEMENT OF THYROID-NODULES DURING PREGNANCY

Guidelines for the management of thyroid nodules discovered during pre gnancy have not yet been established. The authors reviewed the records of 23 patients with thyroid nodules that were first detected during p regnancy, These patients were divided into three groups according to h ow they were managed. Seven patients who presented early in pregnancy had their work-up completed during pregnancy, 11 patients underwent bi opsy after delivery, and 5 patients were managed with observation alon e. The incidence of malignancy in the series was 39%, Four patients un derwent surgery during pregnancy, and 7 patients were operated on in t he postpartum period, No fetal morbidity or mortality occurred, The au thors recommend that fine-needle aspiration be performed in patients w ho present before 20 weeks of gestation with rapidly enlarging thyroid nodules, nodules associated with palpable cervical adenopathy, solid nodules larger than 2 cm, or cystic nodules larger than 4 cm, Growth o f a nodule while a patient is receiving thyroid hormone suppression th erapy is highly suspicious for malignancy; in this situation, consider ation should be given to performing biopsy later in gestation,