Endocrine Abstracts (2009) 20 P651

Screening of maternal thyreopathies in Slovakia: is it worth it?

Helena Urbankova1, Jan Hruska2 & Peter Vanuga1

1Department of Endocrinology, National Institute of Endocrinology and Diabetology, Lubochna, Slovakia; 2Gynecology Outpatient Service, Ruzomberok, Slovakia.

Background: Newborn screening is the only systematic work-up of thyroid disorders in Slovakia with unambigously proven positivities. There is wide discussion regarding the screening of thyreopathies in specific risk groups such as pregnant women.

Aims: To study the gynaecologist and endocrinologist co-operation in screening pregnant patients from region of Liptov and Orava for autoimmune thyroiditis.

Subjects and methods: The participants were 183 pregnant patients (mean age 29 years) in the first trimester without previous endocrinological investigation. They underwent one day out-patient examination and were screened for TSH, fT4, fT3 levels, thyroid antibodies against thyroglobuline and thyroid peroxidase. At the same time, thyroid ultrasonography was performed blindly to determine the patients’ functional thyroid status.

Results: Based on positive thyroid antibodies, autoimmune thyroiditis was diagnosed in 36 (19.7%) pregnant women. From these, 29 (15.8%) were euthyroid, 5 (2.7%) were hypothyroid, and 2 (1.7%) had hyperthyroidism (Graves disease). Moreover, 23 (12.5%) patients were shown to have non-autoimmune nodular and/or cystic changes in thyroid gland. The papillary thyroid cancer was diagnosed in one patient.

Conclusions: The practice management guidelines for thyroid disorders in pregnant females are missing in Slovakia. High prevalence of autoimmune thyroiditis in our pilot study argue for their early intervention. At least, it is reasonable to screen the patients with positive family history and/or personal history of thyroid diseases at the beginning of the pregnancy or even better preconceptually.

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