{"id":19255,"date":"2026-04-10T13:53:05","date_gmt":"2026-04-10T11:53:05","guid":{"rendered":"https:\/\/cptsdracenie.fr\/?page_id=19255"},"modified":"2026-04-10T16:03:38","modified_gmt":"2026-04-10T14:03:38","slug":"grossesse-et-thyroide","status":"publish","type":"page","link":"https:\/\/cptsdracenie.fr\/index.php\/mission-de-sante\/parcours-de-soins\/parcours-parentalite\/grossesse-et-thyroide\/","title":{"rendered":"Grossesse et thyro\u00efde"},"content":{"rendered":"
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Retour formation du 07.04.2026<\/h5>\r\n <\/div>\r\n <\/div>\r\n
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Grossesse et thyro\u00efde <\/h2>\r\n <\/div>\r\n <\/div>\r\n
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Un enjeux pour le bien \u00eatre d ela maman et la bonne sant\u00e9 du b\u00e9b\u00e9<\/p>\r\n <\/div>\r\n <\/div>\r\n

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Arbre d\u00e9cisionnel HAS 2023<\/span><\/a>\r\n <\/span>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n
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Grossesse et thyro\u00efde <\/h1>\r\n

Surveillance de la TSH et recommandations HAS <\/p>\r\n

La grossesse entra\u00eene des modifications importantes de la fonction thyro\u00efdienne. Une surveillance adapt\u00e9e permet de pr\u00e9venir les complications maternelles et f\u0153tales. <\/p>\r\n <\/div>\r\n \r\n

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Grossesse et fonction thyro\u00efdienne<\/h2>\r\n

Pendant la grossesse, plusieurs m\u00e9canismes modifient la thyro\u00efde : <\/p>\r\n

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  • Augmentation des besoins en iode<\/li>\r\n
  • Stimulation thyro\u00efdienne par l\u2019hCG (\u2193 TSH au 1er trimestre)<\/li>\r\n
  • Augmentation de la TBG (effet des \u0153strog\u00e8nes)<\/li>\r\n
  • Modification de l\u2019immunit\u00e9 maternelle<\/li>\r\n <\/ul>\r\n

    Ces variations peuvent r\u00e9v\u00e9ler ou aggraver une pathologie thyro\u00efdienne. <\/p>\r\n <\/div>\r\n \r\n

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    R\u00f4le des hormones thyro\u00efdiennes<\/h2>\r\n
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    • D\u00e9veloppement neurologique f\u0153tal<\/li>\r\n
    • Croissance<\/li>\r\n
    • Maturation c\u00e9r\u00e9brale<\/li>\r\n <\/ul>\r\n

      \ud83d\udccc Au 1er trimestre, le f\u0153tus d\u00e9pend enti\u00e8rement des hormones maternelles. <\/p>\r\n <\/div>\r\n \r\n

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      D\u00e9pistage : cibl\u00e9 et non syst\u00e9matique<\/h2>\r\n
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      Facteurs de risque<\/h3>\r\n
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      • \u00c2ge > 35 ans<\/li>\r\n
      • IMC > 40<\/li>\r\n
      • Ant\u00e9c\u00e9dent thyro\u00efdien<\/li>\r\n
      • Maladie auto-immune \/ diab\u00e8te type 1<\/li>\r\n
      • Infertilit\u00e9 ou fausses couches<\/li>\r\n
      • Anti-TPO positifs<\/li>\r\n
      • Traitement (amiodarone, lithium)<\/li>\r\n <\/ul>\r\n <\/div>\r\n
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        Examen recommand\u00e9<\/h3>\r\n

        Dosage de la TSH en premi\u00e8re intention<\/strong><\/p>\r\n

        Pas de d\u00e9pistage syst\u00e9matique en population g\u00e9n\u00e9rale.<\/p>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n \r\n

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        Hypothyro\u00efdie maternelle : risques<\/h2>\r\n
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        Pour la m\u00e8re<\/h3>\r\n
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        • Infertilit\u00e9<\/li>\r\n
        • Fausse couche<\/li>\r\n
        • Pr\u00e9maturit\u00e9<\/li>\r\n
        • Pr\u00e9-\u00e9clampsie<\/li>\r\n <\/ul>\r\n <\/div>\r\n
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          Pour le f\u0153tus<\/h3>\r\n
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          • Retard neuro-d\u00e9veloppemental<\/li>\r\n
          • Alt\u00e9ration du QI<\/li>\r\n
          • Troubles neurologiques<\/li>\r\n <\/ul>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n \r\n
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            Conduite \u00e0 tenir (HAS)<\/h2>\r\n
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            TSH < 2,5<\/h3>\r\n

            Pas de prise en charge sp\u00e9cifique<\/p>\r\n <\/div>\r\n

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            TSH 2,5 \u2013 4<\/h3>\r\n
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            • Dosage anti-TPO<\/li>\r\n
            • Si positifs \u2192 traitement discut\u00e9<\/li>\r\n <\/ul>\r\n <\/div>\r\n
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              TSH > 4<\/h3>\r\n

              Traitement par l\u00e9vothyroxine<\/strong> recommand\u00e9 <\/p>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n \r\n

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              Traitement et objectifs<\/h2>\r\n
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              • L\u00e9vothyroxine (LT4)<\/li>\r\n
              • Augmentation dose +25 \u00e0 30 % d\u00e8s d\u00e9but grossesse<\/li>\r\n
              • Objectif : TSH < 2,5 mUI\/L<\/strong><\/li>\r\n <\/ul>\r\n <\/div>\r\n \r\n
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                Surveillance biologique<\/h2>\r\n
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                • TSH tous les mois jusqu\u2019\u00e0 22 SA<\/li>\r\n
                • Puis entre 30\u201334 SA<\/li>\r\n
                • Contr\u00f4le \u00e0 6 semaines post-partum<\/li>\r\n <\/ul>\r\n <\/div>\r\n \r\n
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                  Suppl\u00e9mentation en iode<\/h2>\r\n
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                  • Besoins : 200\u2013250 \u00b5g\/j<\/li>\r\n
                  • Compl\u00e9ment recommand\u00e9 : 100\u2013150 \u00b5g\/j<\/li>\r\n
                  • \u00c0 d\u00e9buter en pr\u00e9conception ou d\u00e9but de grossesse<\/li>\r\n
                  • \u00c0 poursuivre pendant l\u2019allaitement<\/li>\r\n <\/ul>\r\n <\/div>\r\n \r\n
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                    Message cl\u00e9<\/h2>\r\n

                    Le d\u00e9pistage cibl\u00e9 et la surveillance r\u00e9guli\u00e8re de la TSH permettent de pr\u00e9venir les complications maternelles et f\u0153tales. Une prise en charge pr\u00e9coce est essentielle, surtout au 1er trimestre. <\/p>\r\n <\/div>\r\n <\/section>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n<\/div>","protected":false},"excerpt":{"rendered":"

                    Retour formation du 07.04.2026 Grossesse et thyro\u00efde  Un enjeux pour le bien \u00eatre d ela maman et la bonne sant\u00e9 du b\u00e9b\u00e9 Arbre d\u00e9cisionnel HAS 2023 Grossesse et thyro\u00efde Surveillance de la TSH et recommandations HAS La grossesse entra\u00eene des modifications importantes de la fonction thyro\u00efdienne. Une surveillance adapt\u00e9e permet de pr\u00e9venir les complications maternelles […]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":19261,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"page-templates\/full-width-page.php","meta":{"footnotes":""},"class_list":["post-19255","page","type-page","status-publish","hentry"],"yoast_head":"\nGrossesse et thyro\u00efde – Communaut\u00e9 Professionnelle Territoriale de Sant\u00e9 Drac\u00e9nie Provence Verdon<\/title>\n<meta name=\"description\" content=\"La surveillance cl\u00e9 essentielle pour le bien \u00eatre de la maman et la sant\u00e9 de b\u00e9b\u00e9. 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