Posthemithyroidectomy Pregnancy Thyroid Function Surveillance: Frequency, Adherence, and Guideline Impact.

Area of Science:

• Endocrinology
• Obstetrics & Gynecology
• Surgical Oncology

Background:

• Women who have undergone hemithyroidectomy face an elevated risk of gestational subclinical hypothyroidism.
• The American Thyroid Association (ATA) advises enhanced thyroid function monitoring for this high-risk pregnancy subgroup.
• Evaluating adherence to the 2017 ATA guidelines is crucial for understanding current surveillance practices.

Purpose of the Study:

• To determine the frequency of thyroid function surveillance during pregnancy in women post-hemithyroidectomy.
• To assess adherence to the 2017 ATA guidelines for thyroid function surveillance.
• To evaluate the impact of the 2017 ATA guidelines on surveillance rates.

Main Methods:

• A retrospective analysis of pregnant women who underwent hemithyroidectomy between 1997 and 2020.
• Cohort divided into pre-2018 and post-2018 groups to assess the 2017 ATA guideline impact.
• Guideline adherence defined as at least one thyroid-stimulating hormone test per trimester.

Main Results:

• 120 pregnancies in 66 women were analyzed.
• Thyroid-stimulating hormone testing rates were 86.6% (1st trimester), 40% (2nd trimester), and 16.6% (3rd trimester).
• Rates post-2018 showed no significant improvement: 88% (1st), 40% (2nd), and 8% (3rd trimester).

Conclusions:

• Adherence to current ATA guidelines for thyroid function surveillance in post-hemithyroidectomy pregnancies is notably low.
• The publication of the 2017 ATA guidelines has not demonstrably improved surveillance rates.
• Enhanced patient education and interdisciplinary communication are essential to improve monitoring.