The Questions About Thyroid Disease and Pregnancy That One-Third of All Doctors Can't Correctly Answer

According to a new study published in the journal Thyroid, one-third of the doctors surveyed could not correctly answer all of the following pregnancy/thyroid-specific questions. (Surprisingly, the doctors surveyed included thyroid experts and obstetrician-gynecologists.)

Here are the questions from that survey:

• What percentage of women in the US develops post-partum thyroiditis?

• Is there an increased risk of women developing post-partum thyroiditis if they have Type I diabetes?
  a. Yes
  b. No
  c. I don’t know.

• Are there any long-term sequela (conditions that result) for women with post-partum thyroiditis? (Circle one choice.)
  a. There are no long-term sequela
  b. Development of a major depressive disorder
  c. Development of permanent primary hypothyroidism
  d. Development of a thyroid goiter
  
  
• A majority of women with hypothyroidism who are on levothyroxine therapy prior to pregnancy should_____during pregnancy. (Circle one choice)
  a. decrease the dose of levothyroxine
  b. increase the dose of levothyroxine
  c. stop levothyroxine therapy
  d. switch to T3 therapy
  
  
• Can patients with hypothyroidism on Levothyroxine breastfeed their newborns safely?
  a. Yes
  b. No
  c. I don’t know.
  
  
• Recent studies have shown that women with serum TSH concentrations above the 95th percentile in a normal population or T4 concentrations in the lowest 5th percentile of normal have an increased risk of which of the following? (Circle all choices that apply.)
  a. Genetic Malformations
  d. Preeclampsia
  b. Gestational Diabetes Mellitus
  e. Polyhydramniosis
  c. Children with Lower IQ Scores
  
  
• The natural course of Graves disease during pregnancy is an:
  a. exacerbation of symptoms during the first trimester, with an amelioration in the second trimester.
  b. exacerbation of symptoms during the course of pregnancy, with an amelioration post-partum.
  c. amelioration of symptoms during the first trimester, with a second trimester flare.
  d. amelioration of symptoms during the course of pregnancy, with a post-partum flare.
  
  
• In women with Graves’ disease, the therapeutic goal of treatment is to maintain the thyroid status at which of the following levels?
  a. Thyroid function tests in the upper limit of normal.
  b. Thyroid function tests in the middle range of normal.
  c. Thyroid function tests in the lower limit of normal.
  
  
• Euthyroid women positive for thyroid antibodies (thyroid peroxidase and-or thyroglobulin) have an increased risk of? (Please circle all choices that apply)
  a. Post-Partum Thyroiditis
  d. Pre-term delivery
  b. Polyhydramniosis
  e. Miscarriage
  c. Preeclampsia

Source: Rinaldi, Marie, and Alex Stagnaro-Green. Thyroid Disease and Pregnancy: Degrees of Knowledge, Thyroid. 2007, 17(8): 747-753. doi:10.1089/thy.2007.0080.