PREGNANCY COMPLICATIONS IN MATERNAL'S HYPERTHYROIDISM AND HYPOTHYROIDISM
Keywords:
thyroid stimulating hormone (TSH), spontaneous abortion, hyperthyroidism, hypothyroidismAbstract
A healthy thyroid gland is a factor for successfully coping with the increased physiological demands of pregnancy. Diseases of the thyroid gland, whether manifest or subclinical thyroid dysfunction, affect pregnancy at all trimesters, especially in the first trimester. The fetal thyroid gland begins to produce thyroid hormones after the 18th week of gestation, therefore maternal thyroid hormones are necessary for normal development and growth of the fetus in the first trimester. Maternal hyperthyroidism and hypothyroidism during pregnancy is a predictive factor that increases feto maternal and neonatal morbidity and mortality.
The objective is to determine the prevalence of thyroid disorders in the mother and their relationship with the fetal outcome, as well as to change the management of the patients in the direction of achieving an optimal serum level of thyroid stimulating hormone.
Laboratory tests are used to assess thyroid function in 69 patients and data from questionnaires obtained by a survey method for: birth weight of live births from successful pregnancies, number of spontaneous losses of early pregnancy, personal and family history of thyroid disease and obstetric history.
The treatment of hypothyroidism, subclinical hypothyroidism and hyperthyroidism show a positive result where no deviation is noted in the birth weight of a fetus from a mother with a personal history of thyroid disease that has been treated and without thyroid pathology. The role of AntiTPO Ab still remains a field of research where in our case no significant difference was recorded between the exposed and investigated group. The average gestational week of spontaneous abortion was 8 weeks of gestation. The average value of TSH in patients who had a miscarriage in early pregnancy was 2.55 mU/L, SD of TSH 1.54 mU/L, where a significant difference was obtained from the value of TSH in the group of subjects without spontaneous abortion (p=0.054)
Any change in the level of thyroid hormones in the mother affects the feto maternal complex, and the determination of serum TSH should be included in the routine investigation of thyroid dysfunction. In this way, spontaneous early pregnancy loss due to thyroid disease will be prevented and women who are at risk for other pregnancy complications will be identified and recognized. Through early screening, therapy would be initiated on time: before conception or very early in the first trimester.
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