title: An international survey of screening and management of hypothyroidism during pregnancy in Latin America.
abstract: OBJECTIVE
  To determine how endocrinologists in Latin America deal with clinical case scenarios related to hypothyroidism and pregnancy.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Biorregulation, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
authors: Mateus Fernandes da Silva
authors: MF
authors: Medeiros
authors: Department of Biorregulation, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
authors: Taise Lima de Oliveira
authors: TL
authors: Cerqueira
authors: Department of Biorregulation, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
authors: Joaquim Custódio
authors: JC
authors: Silva Junior
authors: State University of Feira de Santana, Feira de Santana, BA, Brazil.
authors: Magali Teresopolis Reis
authors: MT
authors: Amaral
authors: Department of Endocrinology, Royal Devon & Exeter Hospital, Exeter, United Kingdom.
authors: Bijay
authors: B
authors: Vaidya
authors: Department of Endocrinology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors: Kris Gustave
authors: KG
authors: Poppe
authors: Division of Endocrinology and Metabolism, Department of Medicine, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Gisah Amaral de
authors: GA
authors: Carvalho
authors: Thyroid Sections, Durand Hospital, Buenos Aires, Argentina.
authors: Silvia
authors: S
authors: Gutierrez
authors: Thyroid Sections, Durand Hospital, Buenos Aires, Argentina.
authors: Graciela
authors: G
authors: Alcaraz
authors: Thyroid Sections, Durand Hospital, Buenos Aires, Argentina.
authors: Marcos
authors: M
authors: Abalovich
authors: Department of Biorregulation, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
authors: Helton Estrela
authors: HE
authors: Ramos
mesh_terms: D000328:Adult; D005060:Europe; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy*; D007843:Latin America; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy*; D012955:Societies, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013961:Thyroid Gland / Q000276:immunology; D013972:Thyrotropin / Q000032:analysis; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D013972:Thyrotropin; D013974:Thyroxine