Shrestha A, Tripathi P, Dongol A
Department of Obstetrics and Gynecology Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.
Kathmandu Univ Med J (KUMJ). 2019;17(65):57-60.
Background Pregnancy is an important event in reproductive years of women life. It has a reversible effect on the thyroid gland and its functions. The role of thyroid gland function and conception has been known for a long time. The most common thyroid gland dysfunction in pregnancy is hypothyroidism. It is estimated that the prevalence is 1.5-4.4% of pregnant women. It is known to cause complications during pregnancy leading to adverse pregnancy outcomes. Objective To observe the pregnancy outcomes in patients with hypothyroidism. Method This is a retrospective study conducted from January 2015 to December 2018. Two hundred and thirty nine patients with hypothyroidism were included. They were investigated for thyroid stimulating hormone (TSH), free tri iodothyronin (FT ), free thyroxine (FT ) levels and for auto-antibodies against thyroperoxidase (anti TPO). All these patients after the detection of hypothyroidism were under thyroxine hormone replacement. Result Amongst 239 ladies with hypothyroidism 97.5% came from hilly region. Seventy seven (32%)of them had history of abortions. Twenty three (9.8%) of them had antepartum hemorrhage. Eleven (4.6%) had preeclampsia during this pregnancy. Seven (2.9%) had fetuses with intrauterine growth restriction (IUGR). Seven (2.9%) had fetuses with preterm delivery. Twenty seven (11.3%) of fetuses had APGAR Score of < 6. Conclusion Of 239 women with hypothyroidism, many had history of recurrent abortions and also complications during antenatal period like preeclampsia, abruption placenta, IUGR and preterm delivery. After thyroxine replacement, risk is much lowered and it has a positive outcome.
背景 怀孕是女性生育期的一个重要事件。它对甲状腺及其功能有可逆性影响。甲状腺功能与受孕的关系早已为人所知。孕期最常见的甲状腺功能障碍是甲状腺功能减退。据估计，其在孕妇中的患病率为1.5 - 4.4%。已知它会在孕期引发并发症，导致不良妊娠结局。目的 观察甲状腺功能减退患者的妊娠结局。方法 这是一项于2015年1月至2018年12月进行的回顾性研究。纳入了239例甲状腺功能减退患者。对她们进行促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT₃）、游离甲状腺素（FT₄）水平以及抗甲状腺过氧化物酶自身抗体（抗TPO）的检测。所有这些患者在被检测出甲状腺功能减退后均接受甲状腺激素替代治疗。结果 在239例甲状腺功能减退的女性中，97.5%来自山区。其中77例（32%）有流产史。23例（9.8%）发生产前出血。11例（4.6%）在此次妊娠期间发生子痫前期。7例（2.9%）胎儿有宫内生长受限（IUGR）。7例（2.9%）胎儿早产。27例（11.3%）胎儿阿氏评分<6分。结论 在239例甲状腺功能减退的女性中，许多人有反复流产史，并且在孕期还出现了子痫前期、胎盘早剥、IUGR和早产等并发症。甲状腺素替代治疗后，风险大大降低，且有积极的结果。
