[Unveiling Hormonal Secrets]

Background: Thyroid dysfunction during pregnancy negatively impacts both the woman and her offspring, with the early gestational period being critical for potential repercussions. Establishing pre-conception and during-conception care strategies is crucial for favorable pregnancy outcomes. Objective: This review aims to compile the most recent scientific evidence to guide diagnostic and therapeutic approaches based on clinical cases, including a description of thyroid physiology during pregnancy and strategies for identifying high-risk patients for treatment. Method: This bibliographic review combined DeCS and MeSH terms from the PICOT question, spanning the period from 2015 to 2022 across 5 databases. Articles in both English and Spanish were included if they addressed the PICOT question and contributed to the explanation of two case reports. Results: A total of 1452 articles were collected, which, following an initial elimination of duplicates and subsequent blind review based on inclusion and exclusion criteria by two reviewers, resulted in 32 articles included in this review. Conclusions: Overt hypothyroidism is associated with adverse maternal-fetal outcomes, and its treatment improves these complications. However, in borderline conditions such as subclinical hypothyroidism, isolated hypothyroxinemia, and thyroid autoimmune conditions, uncertainty about the treatment's impact persists due to a scarcity of controlled trials. Emphasizing the importance of all physicians being familiar with this condition during gestation.