Diagnosing and managing thyroid disorders during pregnancy: a survey of obstetrician-gynecologists.
OBJECTIVE
To document the knowledge and clinical practice of obstetrician-gynecologists regarding their diagnosis and management of thyroid disorders during pregnancy.


METHODS
We surveyed 1,392 practicing obstetrician-gynecologists about their knowledge and clinical practice of treating thyroid disorders during pregnancy; 569 of the surveys were returned. Of those, 441 respondents treated pregnant women and completed the entire survey.


RESULTS
A majority of respondents had treated patients for hypothyroidism (88.7%) and hyperthyroidism (60.5%) within the previous year. In general, respondents appeared to be well versed in the symptoms of hypothyroidism and hyperthyroidism. Most respondents correctly predicted the likely results for thyroid-stimulating hormone, free thyroxine and total thyroxine for pregnant euthyroid, hyperthyroid and hypothyroid women, but about 50% appeared uncertain of the meaning of free thyroxine index. A majority (53.1%) of respondents considered their training during residency concerning thyroid disorders during pregnancy to be adequate, but few (7.5%) considered it to be comprehensive, and the remainder considered it barely adequate at best. Self-assessment of training and confidence regarding diagnosing and managing thyroid disorders during pregnancy were in concordance (r = .462 and r = .464, respectively; P < .001 in both cases).


CONCLUSIONS
Thyroid disorders are commonly treated by obstetrician-gynecologists, and in general their practices for diagnosis and management conform to accepted practices. A sizable minority of responding obstetrician-gynecologists indicated that they considered their training to be inadequate and their confidence in diagnosing and managing thyroid disorders to be low.
Power
Michael L
ML
Department of Research, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA. mpower@acog.org
Kilpatrick
Sarah
S
Schulkin
Jay
J
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006176:Gynecology / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000592:standards; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States