Thyroid and Parathyroid Surgery Riskier in Pregnant Women

Researchers from the Yale University School of Medicine and United States Department of Veterans Affairs in Washington have found that worse clinical and economic outcomes appear to be associated with pregnant women who undergo thyroid and parathyroid surgery than women who are not pregnant.

Published in the May issue of the Archives of Surgery, the study compared the clinical and economic outcomes of thyroid and parathyroid surgery performed on 201 pregnant women (average age 29) and a group of 31,155 age-matched, non-pregnant women from 1999 to 2005. The study measured fetal, maternal, and surgical complications as well as in-hospital death, length of stay, and hospital costs.

Lead researcher SreyRam Kuy, MD, and colleagues found that in comparison to non-pregnant women, the pregnant patients had a higher rate of endocrine complications (15.9% vs 8.1%) and a higher rate of general complications (11.4% vs 3.6%). Pregnant women also experienced “longer unadjusted lengths of stay (two days vs. one day) and higher unadjusted hospital costs ($6,873 vs. $5,963)…The fetal and maternal complication rates were 5.5 percent and 4.5 percent, respectively.” The pregnant women also had a higher number of surgical complications and malignant thyroid diseases while undergoing thyroidectomy.

Rates of complications also differed by race. “When compared to non-pregnant women of the same race, white pregnant patients had double the complication rate (21 percent vs. 10 percent), black pregnant patients had nearly five times the complication rate (48 percent vs. 10 percent) and Hispanic pregnant patients had an almost three-fold higher complication rate (30 percent vs. 12 percent).”

The authors concluded that that thyroid and parathyroid surgery during pregnancy should be carefully deliberated on whether the benefits offset the potential risks associated with the surgery. The study also notes that the “Surgeon volume is an important predictor of outcomes, so pregnant women undergoing thyroid and parathyroid procedures should be directed to high-volume surgeons whenever possible.”

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