In management of hypothyroidism during pregnancy, what maternal and fetal outcomes are targeted and how is dosing adjusted?

• A. Prevent adverse fetal neurodevelopmental outcomes; increase levothyroxine dose by roughly 25-50% early in pregnancy and monitor TSH each trimester with trimester-specific references.
• B. No special management; dose unchanged.
• C. Decrease dose; switch to PTU.
• D. Stop levothyroxine to avoid fetal exposure.

Answer: (A)