This excellent analysis from the innovative group at Yale confirms a personal bias of mine from about 20 years of practice: pregnant patients requiring endocrine surgery of the neck should be treated with caution, perhaps deferring thyroid cancer surgery until after delivery (or performing lobectomy only during the second trimester) under the supervision of a team of experienced clinicians. This caution is being exercised in practice because pregnant patients more commonly receive care at large urban institutions with high-risk obstetrics.