Background: Overt hyperthyroidism can have a negative impact on pregnancys outcome, if not correctly treated. Furthermore anti thyroid treatment are burned by possible side effects.
Objectives: We describe the experience of our center in the management of endogenous hyperthyroidism in pregnancy. evaluating the effects of the disease and treatments on fetal and maternal health.
Methods: We observed 36 pregnancies (4 twins and 1 triplet, 42 fetuses in total). 31 women had active hyperthyroidism, 5 had a history of Graves disease (GD). All patients with a history of GD were on LT4. We excluded women who hadnt ended their pregnancy at the closure of the study. Clinical and biochemical data on maternal and newborn status were collected . According to the etiology of the hyperthyroidism, pregnancies were divided into: GD (17), multinodular toxic goiter (MNG) (4), gestational hyperthyroidism (GH) (10). We also wanted to evaluate the effect of a personal history of GD (HGD) (5).
Results: Hypertension occurred in 6 out of 30 pregnancies (4 GD, 2 GH). Pre-eclampsia complicated 2 pregnancies (1 GB, 1 IG). Placental abruption occurred in one patient affected by GD. No cases of cardiac insufficiency occurred. Pre-term delivery occurred in 16.6% of pregnancy (3 GD, 1 GH, 1 HGD).Only 3.3% of pregnancy were complicate by intrauterine growth restriction (1 GH), and only 6.29 had a lower birthweight (1 GH, 1 GD). 4 newborns were affected by fetal goiter (3GD, 1 HGD). 5 newborns were affected by hyperthyroidism (3 GD, 2 HGD). A natural fetal abortion occurred at the 16th week of gestation in a GD patient. Patients on thioamides did not developed any drug related side effect.
Conclusion: A careful management of hyperthyroidism can reduce the risk of complications. We confirmed that hypertension is more common in hyperthyroid patients than euthyroid. Our data showed that some complications are related to hyperthyroidism while others depend on the etiology of hyperthyroidism.