Thyroid Disease in Pregnancy: A Clinical Survey among Endocrinologists, Gynecologists, and Obstetricians in Israel.

Autor:	Koren R; Department of Internal Medicine A, Assaf Harofeh Medical Center, Zerifin, Israel.; Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Wiener Y; Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel., Or K; Department of Internal Medicine A, Assaf Harofeh Medical Center, Zerifin, Israel.; Department of Endocrine Institute, Assaf Harofeh Medical Center, Zerifin, Israel., Benbassat CA; Department of Endocrine Institute, Assaf Harofeh Medical Center, Zerifin, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Koren S; Department of Endocrine Institute, Assaf Harofeh Medical Center, Zerifin, Israel.; Diabetes Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
Jazyk:	angličtina
Zdroj:	The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2018 Mar; Vol. 20 (3), pp. 167-171.
Abstrakt:	Objectives: To study the current practices in the management of subclinical hypothyroidism (SCH) and thyroid nodules during pregnancy of obstetricians/gynecologists (OB/GYNs) and endocrinologists in Israel. Methods: An electronic questionnaire was sent by email to all members of the Israeli Endocrine Society and the Israel Society of Obstetrics and Gynecology. Questionnaires included demographic data and clinical scenarios with questions regarding the screening and management of pregnant women with SCH, hypothyroxinemia, and a palpable thyroid nodule. The questionnaire for OB/GYNs was slightly modified. Results: We received 90 responses from endocrinologists and 42 responses from OB/GYNs. Among endocrinologists, 39% would repeat a thyroid-stimulating hormone (TSH) test of 2.9 mU/L with normal free thyroxine and treat with thyroxine if the second result was above 2.5 mU/L. Among OB/GYNs, 73% would manage a woman with SCH at the beginning of her pregnancy by themselves and only 22% would start thyroxine after a first TSH result above 2.5 mU/L. Concerning screening, 57% endocrinologists and 71% OB/GYNs recommended screening for thyroid dysfunction in every woman at the beginning of her pregnancy. Among endocrinologists, 54% would order an ultrasound for a palpable thyroid nodule and perform a fine needle aspiration only for suspicious lesions. Conclusions: The medical approach to thyroid disease in pregnant women remains a matter of controversy. Our results support the need for larger and prospective clinical studies.
Databáze:	MEDLINE
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