THYROID-NODULE AND CANCER IN PREGNANT WOM AN

Most thyroid nodules discovered during pregnancy are benign. In this a rticle, we propose a pragmatic attitude for the diagnosis and treatmen t of such nodules, insisting particularly on the importance of thyroid echography and fine needle aspiration. For women who have successfull y been treated for thyroid cancer before pregnancy, we discuss the ada ptation of thyroxine substitution when they become pregnant, the obste trical and fetal risks (spontaneous miscarriage, fetal abnormalities o f the thyroid gland and others), and also potential later risks for th e child, in relation with previous radioactive iodine administration t o the mother. Finally, we evoke more difficult questions, such as the rare instances in which thyroid cancer is discovered during pregnancy, pregnancy occurring during the months immediately following radioiodi ne treatment, and exceptional cases where the therapeutic radioiodine was inadvertently given during pregnancy.