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Treatment and Screening of Hypothyroidism in Pregnancy: Results of a European Survey.
MedLine Citation:
PMID:  22023792     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Maternal hypothyroidism in pregnancy is associated with several adverse outcomes. The Endocrine Society guidelines for the management of thyroid diseases in pregnancy were published in 2007; however, impact of the guidelines in the routine clinical practice is unknown. Therefore, we have carried out a survey of members of the European Thyroid Association to study current practices relating to the management of hypothyroidism in pregnancy.Subjects and methods: In December 2010, we emailed an electronic questionnaire survey based on clinical case scenarios to 605 members of the ETA. Responses from 190 clinician members (from 28 European countries) were analysed.Results: For a pregnant woman with newly diagnosed overt hypothyroidism, most responders initiated a full dose of L-thyroxine. For a woman with hypothyroidism planning pregnancy, 50% recommended increasing the dose of L-thyroxine as soon as pregnancy is confirmed, whilst 43% favoured testing thyroid function before adjusting the dose. Responders used diverse combinations of tests to monitor the dose of L-thyroxine. The target of thyroid function tests that responders aimed to achieve with L-thyroxine was also inconsistent. Forty-two percent responders or their institutions screened all pregnant women for thyroid dysfunction, 43% performed targeted screening of only the high-risk group, whilst 17% did not carry out systemic screening. Timing of the screening, tests used, and criteria for starting treatment and monitoring were variable.Conclusions: There is wide variation in the clinical practice relating to the treatment and screening of hypothyroidism during pregnancy in Europe.
Authors:
Bijay Vaidya; Alicja Hubalewska-Dydejczyk; Peter Laurberg; Roberto Negro; Francesco Vermiglio; Kris Gustave Poppe
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-24
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
B Vaidya, Department of Endocrinology, Peninsula Medical School, Exeter, EX2 5DW, United Kingdom.
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