Buradasınız

Anasayfa » Content

Gebelik ve Tiroid Hastalıkları Olgularının Değerlendirilmesi

Evaluation of cases with pregnancy complicated by thyroid diseases

Key Words:

Keywords (Original Language):

Abstract (2. Language): 
To evaluate the outcomes of the pregnancies complicated by thyroid diseases treated at our clinic and to review the current literature. A total of 117 pregnancies complicated by thyroid diseases treated in our clinic were investigated retrospectively. Free T4 and TSH levels were assessed as thyroid function tests. While thyroid peroxidase and anti-thyroglobulin antibody levels were studied for Hashimoto’s thyroiditis, thyroid stimulating antibodies were evaluated for Graves’ disease. Cases with hypothyroidism were managed by thyroid hormone replacement therapy whereas propylthiouracyl was the drug of choice in patients who suffered hyperthroidism. Out of the 117 pregnant women with thyroid diseases included in the study, 85 had hypothyroidism and 32 had hyperthyroidism. The etiology of hypothyroidism was found to be Hashimoto’s thyroiditis in 24.7 %, iodine deficiency in 30.6 % and thyroidectomy in 44.7 %. In cases with hypothyroidism the rates of intrauterine growth retardation, preterm delivery, preeclampsia and gestational diabetes mellitus were 4.7, 7.1, 3.5 and 9.4 % respectively. In 40 % of the pregnant women with hypothyroidism, the dose of the thyroid replacment therapy has increased and no problems were recorded in the newborns. Among the cases with hyperthyroidism and pregnancy, 78.1 % had Graves’ disease and 21.9 % had hyperactive thyroid nodules. In hyperthyroidism patients, the rates of intrauterine growth retardation, preterm labor, preeclampsia and gestational diabetes were 6.2, 12.5, 9.3 and 6.3 % respectively. The fetuses and the newborns had no significant problems. The undesired consequences of the thryoid diseases for both the fetus and the mother can be prevented by the cooperative intervention of the experienced obstetricians and endocrinologists.
Bookmark/Search this post with
FULL TEXT (PDF): 
PDF icon arastirmax-gebelik-tiroid-hastaliklari-olgularinin-degerlendirilmesi.pdf
  • 1
  • Turkish

REFERENCES

References: 

1. Thyroid Disease in Pregnancy, ACOG practice bulletin.
Int J Gynecol Obstet 2002; 79: 171-180.
2. Mazzaferri EL. Evaluation and management of disor50
R. MADAZLI ve ark.
ders in women common thyroid. Am J Obstet Gynecol
1997; 176: 507-514.
3. Girling JC. Thyroid disorders in pregnancy. Curr Obstet
Gynaecol 2003; 13: 45-51.
4. Glinoer D. The systematic screening and management
of hypothyroidism and hyperthyroidism during pregnancy.
Trends Endocrinol Metab 1998; 9: 403- 411.
5. Klein RZ, Haddow JE, Faix JD, et al. Prevalence of
thyroid deficiency in pregnant women. Clin Endocrinol
1991; 35: 41-46.
6. Harborne LR, Alexander CE, Thomson AJ, et al. Outcomes
of pregnancy complicated by thyroid disease.
Aust N Z J Obstet Gynecol 2005; 45: 239-242.
7. Mandel SJ. Hypothyroidism and chronic autoimmune
thyroiditis in the pregnant state: maternal aspects.
Best Prac Res Clin Endoc Metob 2004; 18: 213-224.
8. Haddow JE, Palomaki GE, Allan WC et al. Maternal
thyroid deficiency during pregnancy and subsequent
neuropsychological development of the child. N Engl
J Med 1999; 341: 548-555.
9. Pop VJ, Brouwers EP, Vader HL, et al. Maternal hypothyroxinaemia
during early pregnancy and subsequent
child development: a 3-year follow-up study. Clin Endocrinol
2003; 59: 282-288.
10. Burrow GN. The management of thyrotoxicosis in
pregnancy. N Engl J Med 1985; 313: 562–565.
11. Hague WM. Pre-existing endocrine disease in relation
to pregnancy-thyroid disorders. Current Obstet Gynecol
1999; 9: 63-68.
12. Uluda¤ S, Goker B, Gezer A, ve ark. Gebelikte tiroid
krizi:olgu sunumu. Jinekoloji ve Obstetrik Dergisi
2003; 17: 118-121.
13. Ecker JC, Musci TJ. Thyriod function and disease in
pregnancy. Curr Prob Obstet Gynecol Fertil 2000;
23: 109-122.
14. Brent GA, Hershman JM. Thyroid disease and pregnancy.
Encyclop End Dis 2004; 4: 395- 400.
15. Glinoer D. Management of hypo-and hyperthyroidism
during pregnancy. Growth Hormone & IGF Research
2003; 13: 45-54.
16. Abalovich M, Gutierrez S, Alcaraz G, et al. Overt and
subclinical hypothyroidism complicating pregnancy.
Thyroid 2002; 12: 63–68.
17. Alexander EK, Marqusee E, Lawrence J, et al. Timing
and magnitude of increases in levothyroxine requirements
during pregnancy in women with hypothyroidism.
N Engl J Med 2004; 351: 241–249.
18. Idris I, Srinivasan R, Simm A, Page RC. Maternal hypothyroidism
in early and late gestation: effects on
neonatal and obstetric outcome. Clin Endocrinol
2005; 63: 560-565.
19. Zoeller RT, Rovet J. Timing of Thyroid Hormone Action
in the Developing Brain: Clinical Observations and
Experimental Findings. J Neuroendocrinol 2004; 16:
809-818.
20. Mestman JH. Hyperthyroidism in pregnancy. Best
Prac Res Clin Endocrinol Metab, 2004; 18; 267-288.
21. Girling JC. Thyroid disorders in pregnancy. Curr Obstet
Gynaecol 2006; 16: 47–53.
22. Nachum Z, Rakover Y, Weiner E, Shalev E. Graves’
disease in pregnancy: Prospective evaluation of a
selective invasive treatment protocol. Am J Obstet
Gynecol 2003; 189: 159-165.
23. Kilpatrick S. Umbilical blood sampling in women
with thyroid disease in pregnancy: Is it necessary?
Am J Obstet Gynecol 2003; 189: 1-2.

Thank you for copying data from http://www.arastirmax.com