Introduction: In accordance with a rising number of pregnant women with thyroid gland dysfunctions, The Thyroid Glands Disorders Outpatient Clinic for Pregnant Women has started its activity in our Endocrinology Department in January 2008. Patients with or without thyroid gland dysfunction in history have been under medical care.
During pregnancy thyroid gland is prone to the number of physiological changes, which cause difficulties in the interpretations of thyroid hormones results. Changes in estrogens level and TBG concentration, activity of hCG make TSH level inadequate. Transitory increase of FT4 and FT3 levels in first trimester is observed. However, in second and third trimester mainly FT4 level could be slightly decreased. Increased aTPO level detected during pregnancy has been shown to be associated with 24× higher risk of miscarriage.
Aims: (1) Attempt of establishing the referential norms of the FT3, FT4 in each trimester.
(2) Establishing the referential norms of TSH in each trimester.
(3) Morphological changes in thyroid gland in usg examination during pregnancy
(4) Evaluation of the aTPO/hTrab level for post partum thyroid disease risk assessment
Method: Assay of the FT3, FT4, TSH level and aTPO/ hTrab in blood serum (ECL) during 1st, 2nd and 3rd trimester of pregnancy, thyroid USG.
Results: About 173 pregnant women were examined from January 2008 till present day. Mean value of TSH for healthy women was as follows: 0.65 uIU/ml (±0.6), 1.16 uIU/ml(±0.48), 1.35 uIU/ml (±0.51) in 1st 2nd, 3rd trimester respectively. Abnormal result of aTPO have 43 patients (24.7%).
Conclusion: Establishment of reference values for each trimester is fundamental for correct assessment of thyroid function in pregnancy. About 1/4 patients have increased result of aTPO and required further observation. Our researches need to be continued.
25 - 29 Apr 2009
European Society of Endocrinology