; Ish-Shalom, Maya2;
; Fliss, Dan M.1
; Comaneshter, Doron3
; Vinker, Shlomo3,4
1 Otolaryngology, Head & Neck Surgery, Tel Aviv “Sourasky” Medical Center, “Sackler” School of Medicine, Tel Aviv University, Tel Aviv, Israel
2 Endocrinology, Metabolism & Hypertension, Tel Aviv “Sourasky” Medical Center, “Sackler” School of Medicine, Tel Aviv University, Tel Aviv, Israel
3 Chief Physician Office, Clalit Health Services, Tel Aviv, Israel
4 Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
The toal number of thyroidectomies performed worldwide has increased dramatically. Hypothyroidism during pregnancy is assumed to have deleterious effects on the fetus and pregnancy outcomes.
To assess thyroid function control among pregnant women who had previously undergone a therapeutic thyroidectomy (total or partial).
Retrospective cohort study of all female patients insured in the largest health maintenance organization in Israel who were pregnant between May, 2001 and September, 2012 and had a medical history of thyroid surgery. TSH levels were evaluated throughout the pregnancy. A multivariate analysis was performed to determine risk factors for not attaining recommended TSH levels for each trimester.
A total of 477 females with a history of thyroid surgery had given 701 births during the study period. 43% (n=203) had been diagnosed as having malignant thyroid disease. Nearly half of the women underwent total thyroidectomy (43.4%; n=207). The women’s TSH values were within the recommended range in only 60% (n= 350) of the pregnancies during the first trimester, in 61% (n=335) during the second trimester, and in 70% (n=338) during the third trimester. In multivariate analysis, women that underwent total thyroidectomy due to benign thyroid disease were at risk for not attaining target TSH levels during pregnancy.
large cohort of women with a past history of thyroid surgery, demonstrated a significant percentage of pregnancies with TSH values above the recommended values for each trimester. Women that underwent a total thyroidectomy due to benign thyroid disease were less likely to attain target TSH values during pregnancy.