Endocrine Abstracts (2009) 20 P96

When antithyroid drugs must be started in patients with hyperemesis gravidarum?

Farzad Najafipour & Amir Bahrami


Department of Endocrinology and Metabolism, Emam Reza Hospital, Tabriz University of Medical sciences, Tabriz, Islamic Republic of Iran.


Hyperemesis gravidarum is characterized by prolonged, severe nausea and vomiting in early pregnancy that. It occurs in about 1.5% of pregnancies and is more common in Asian women than in white women. Many patients do not need anti thyroid drugs, except in patients with severe nausea and vomiting and thyroid dysfunction after 18–20 weeks of pregnancy.

Material and methods: One hundred and thirty-five patients with hyperemesis gravidarum whom admitted to Ob- Gyn hospital were selected. After excluding criteria, 103 patients underwent investigations including thyroid function test and β-hCG.

Results: Thirty-five women were found abnormal thyroid function test with FT4I 4.74±0.54 and in another group (68 women) was 2.9±0.39 (P<0.0001). B-hCG in first group was 59 406±14 899 miu/ml and in second group was 6750±3476 miu/ml (P<0.0001). In 5 patients PTU started due to severe sign and symptoms of hyperthyroidism. Thyroid function test rechecked for all of 35 patients after 4 weeks routine therapy for hyperemesis gravidarum. Thyroid function test was normalized in 11 patients with hyperemesis graridarum but was abnormal in 22 patients so PTU was started and anti-TPO anti-body was measured. Thyroid function test was done for all of them monthly and PTU adjusted with the thyroid function test. Means of the therapy was 2.76 months and 60.63 mg/d for Anti-TPO negative and 5.33 months and 170 mg/d for anti-TPO positive patients.

Conclusion: In our study, thyroid dysfunction in hyperemesis gravidarum was 35% and, 20% of patients needed anti-thyroid therapy. Routine assessment of thyroid function is necessary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. We must consider PTU in hyperemesis gravidarum with severe weight loss, vomiting and biochemical hyperthyridism. We reported a female predominance among offspring of mothers with hyperemesis gravidarum.

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