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    An international survey of screening and management of hypothyroidism during pregnancy in Latin America

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    URI
    http://hdl.handle.net/11287/593827
    Author
    Medeiros, M. F.
    Cerqueira, T. L.
    Silva Junior, J. C.
    Amaral, M. T.
    Vaidya, Bijay
    Poppe, K. G.
    Carvalho, G. A.
    Gutierrez, S.
    Alcaraz, G.
    Abalovich, M.
    Ramos, H. E.
    Latin American Thyroid, Society
    Date
    2014-12-01
    Journal
    Arquivos brasileiros de endocrinologia e metabologia
    Type
    Journal Article
    Research Support, Non-U.S. Gov't
    Publisher
    Arq Bras Endocrinol Metabol
    DOI
    10.1590/0004-2730000003382
    Metadata
    Show full item record
    Abstract
    OBJECTIVE: To determine how endocrinologists in Latin America deal with clinical case scenarios related to hypothyroidism and pregnancy. MATERIALS AND METHODS: In January 2013, we sent an electronic questionnaire on current practice relating to management of hypothyroidism in pregnancy to 856 members of the Latin American Thyroid Society (LATS) who manage pregnant patients with thyroid disease. Subsequently, we have analyzed responses from physician members. RESULTS: Two hundred and ninety-three responders represent clinicians from 13 countries. All were directly involved in the management of maternal hypothyroidism and 90.7% were endocrinologists. The recommendation of a starting dose of L-thyoxine for a woman diagnosed with overt hypothyroidism in pregnancy, preconception management of euthyroid women with known thyroid autoimmunity and approach related to ovarian hyperstimulation in women with thyroid peroxidase antibodies were widely variable. For women with known hypothyroidism, 34.6% of responders would increase L-thyroxine dose by 30-50% as soon as pregnancy is confirmed. With regard to screening, 42.7% of responders perform universal evaluation and 70% recommend TSH < 2.5 mUI/L in the first trimester and TSH < 3 mUI/L in the second and third trimester as target results in known hypothyroid pregnant women. CONCLUSION: Deficiencies in diagnosis and management of hypothyroidism during pregnancy were observed in our survey, highlighting the need for improvement of specialist education and quality of care offered to patients with thyroid disease during pregnancy in Latin America.
    Citation
    Arq Bras Endocrinol Metabol. 2014 Dec;58(9):906-11.
    Publisher URL
    http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302014000900906&lng=en&nrm=iso&tlng=en
    Note
    This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
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    • 2014 RD&E publications
    • Diabetes and endocrinology

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