Hypothyroidism and pregnancy: Diagnostic and therapeutic dilemmas in modern management algorithms

Hypothyroidism, characterized by a deficiency of thyroid hormones, is a common endocrine pathology in women of reproductive age, which is a significant problem during pregnancy. Insufficient thyroid function has a negative impact on maternal health and fetal development, increasing the risk of gestational hypertension, premature birth, placental abruption and impaired neurocognitive development of offspring. Timely diagnosis and adequate hormone replacement therapy play a key role in preventing adverse outcomes. The article provides an overview of current data on the pathogenesis, diagnosis, and treatment of hypothyroidism during pregnancy, including screening issues, target levels of thyroid-stimulating hormone, and features of interpretation of laboratory parameters. Special attention is paid to the choice of the optimal form of levothyroxine, which is the first-line drug for hormone replacement therapy of hypothyroidism. The potential advantages of using the liquid form of levothyroxine, characterized by improved absorption, minimizing the influence of factors that reduce bioavailability, and the possibility of accurate dosage, which is especially important in conditions of physiological changes occurring in the body of a pregnant woman, are considered.