Evaluation of the cases of hyper - and hypothyroidism during pregnancy registered in the fıve-year period

 

During the analyzed period there were 11 cases of hyper- and 6 cases of hypothyroidism in pregnancy. The incidence is very low as there are about 6000 deliveries per year in the Department. All cases were diagnosed and treated before pregnancy. The causes were: Graves's disease in all hyperthyroid patients and Hashimoto thyroiditis and previous surgical treatment of hyperthyroidism in cases of hypothyroidism. All of patients have frequently visited the obstetrician and endocrinologist during the pregnancy. Serum hormones analyses were performed several times. Fetal condition was estimated by serial ultrasound examinations and frequent fetal heart rate testing (nonstress test). The mode of delivery depended on the obstetric indications. Blood samples of the newborn were assayed for thyroid hormones. in regard of medication four of hyperthyroid patients took propylthiouracil during the whole pregnancy and one took the same drug from 24th week of gestation because of worsening of the disease. The rest of patients were without the medication in respect of their hormonal status. On the other hand, all the hypothyroid patients were treated with levothyroxine. One of the hyperthyroid patients had the preterm delivery in the 33rd week. The newborns of the mothers with Graves disease weighted from 2200 and 2800 g (IUGR and low birth weight) to 3680 g. in the group of hypothyroid patients there were two cases of PIH and the birth weights varied from 2860 g (low birth weight) to 4050 g. in both groups, there were no newborn with hyper/hypothyroidism in the early neonatal period. it should be mentioned that the patients with hyperemesis gravidarum were much more numerous but routine control of their thyroid hormones level were not performed.