BibTex RIS Kaynak Göster

Thyroid dysfunction during pregnancy and evaluation of its results

Yıl 2011, , 196 - 201, 01.06.2011
https://doi.org/10.5799/ahinjs.01.2011.02.0238

Öz

S Objectives: In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women. Materials and methods: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were studied. Antithyroidal peroxidase (anti-TPO) and Anti-thyroglobulin (anti-Tg) parameters were measured if they were necessary. The relationship between thyroid functions and complications such as eclampsia, preeclampsia, maternal anemia, postpartum hemorrhage, fetal anomalies, shoulder dystocia, neonatal hypoglycemia was examined. Results: Hypothyroidism was found 18 of cases and hyperthyroidism was found 4 of them. The mean age of patients in the study was 26.42 (± 8.42). The mean values were 1.86 ± 0.19 μIU/mL for TSH, 1.15 ± 0.29 ng/mL for free T4 and 2.90 ± 0.31 pg/mL for free T3 respectively. Hashimoto's thyroiditis (9 cases, 50 %) was the most frequent etiology for patients with hypothyroidism. Other etiologic factors for hypothyroidism were found to be for 4 cases as (22.2%), iatrogenic (previously undergone thyroidectomy) and 5 cases as (37.8%) a lack of iodine. Maternal anemia was observed in 5 (27.78%) cases with hypothyroidism. Preeclampsia was observed 16.67% in patients with hypothyroidism. Conclusion: Observed thyroid dysfunction in pregnant women may cause serious maternal and fetal complications. For disorders of thyroid function during pregnancy, to provide the necessary treatment at the appropriate time is important to prevent complications of mother and fetus.

Kaynakça

  • American College of Obstetrics and Gynecology.ACOG practice bulletin. Thyroid disease in pregnancy. Number 37, August 2002. American College of Obstetrics and Gynecology.Int J Gynaecol Obstet 2002;79(2):171-80.
  • Glinoer D, de Nayer P, Bourdoux P, Lemone M, Robyn C, van Steirteghem A, Kinthaert J, Lejeune B.Regulation of maternal thyroid during pregnancy.J Clin Endocrinol Metab 1990;71(2):276-87.
  • Ain KB, Mori Y, Refetoff S. Reduced clearance rate of thyroxinebinding globulin (TBG) with increased sialylation: A mechanism for estrogen-induced elevation of serum TBG concentration. J Clin Endocrinol Metab 1987;65(4):68996.
  • Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 1997;18(3):404-33.
  • Brent GA. Maternal hypothyroidism: recognition and management. Thyroid 1999;9(7):661-5.
  • Brent GA. Maternal thyroid functions: interpretation of thyroid function tests in pregnancy. Clin Obstet Gynecol 1997;40(1):3-15.
  • Pop VJ, Kuijpens JL, Van Baar AL, et al. Low maternal free thyroxine concentrations during early pregnacy are associated with impaired psychomotor development in early infancy. Clin Endocrinol (Oxf) 1999;50(2):149-55.
  • Andersen S, Bruun NH, Pedersen KM, Laurberg P. Biologic variation is important for interpretation of thyroid function tests. Thyroid 2003;13(11):1069-78.
  • Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A, Mitchell ML. Prevalance of thyroid defiency in pregnant women. Clin Endocrinol (Oxf) 1991;35(1):41-6.
  • Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, Cunningham FG. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005;105(2):239-45.
  • Casey BM. Subclinical hypothyoridism and pregnancy. Obstet Gynecol Surv 2006;61(6):415-20;.
  • Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999;341(8):549-55.
  • Pop VJ, Brouwers EP, Vader HL, Vulsma T, van Baar AL, de Vijlder JJ. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol (Oxf) 2003;59(3):282-8.
  • Burrow GN. The management of thyrotoxicosis in pregnancy. N Engl J Med 1985;313(9):562-5.
  • Neale D, Burrow G. Thyroid disease in pregnancy. Obstet Gynecol Clin North Am 2004;31(4):893-905.
  • Ecker JC, Musci TJ. Thyriod function and disease in pregnancy. Curr Prob Obstet Gynecol Fertil 2000; 23(1): 10922.
  • Glinoer D. Management of hypo-and hyperthyroidism during pregnancy. Growth Horm IGF Res 2003;13 Suppl A:S45-54.
  • Lazarus JH. Thyroid dysfunction: reproduction and postpartum thyroiditis. Semin Reprod Med 2002;20(4):381-8.
  • Wasserstrum N, Anania CA. Perinatal consequences of maternal hypothyroidism in early pregnancy and inadequate replacement Clin Endocrinol (Oxf) 1995;42(4):353-8.
  • Lowell ED, Kenneth JL, Cunningham FG. Hypothyroidism complicating pregnancy Obstet Gynecol 1988;72(1):10812.
  • Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ, Faix JD, Klein RZ. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen 2000;7(3):127-30.
  • Glinoer D, De Nayer P, Delange F, et al. A randomized trial for the treatment of mild iodine deficiency during pregnancy: Maternal and neonatal effects. J Clin Endocrinol Metab 1995;80(1):258-69.
  • Mestman JH. Hyperthyroidism in pregnancy. Best Pract Res Clin Endocrinol Metab. 2004;18(2):267-88.
  • Susan J, Mandel SC, David SC. The use of antithyroid drugs in pregnancy and lactation. J Clin Endocrinol Metab 2001;86(6):2354-9.
  • Nader S. Thyroid disease and other endocrine diseasenin pregnancy. Obstet Gynecol Clin North Am 2004;31(2):25785.
  • Girling JC. Thyroid disorders in pregnancy. Curr Obstet Gynaecol 2003;13 (1):45-51.

Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi

Yıl 2011, , 196 - 201, 01.06.2011
https://doi.org/10.5799/ahinjs.01.2011.02.0238

Öz

Amaç: Bu çalışmada, tiroid fonksiyon bozukluğu olan gebelerin
normal gebelere göre obstetrik sonuçlarının değerlendirilmesi amaçlanmıştır.
Materyal ve metot: Çalışmamızda, Kovancılar Devlet
Hastanesi Kadın Hastalıkları ve Doğum Polikliniğine gebe
izlemi için Ocak 2010 ile Ocak 2011 tarihleri arasında başvuran 18 ile 35 yaşları arasındaki 633 kadın değerlendirildi.
Tüm olguların serum tiroid stimülan hormon (TSH),
serbest tri-iyodotironin (T3), serbest tiroksin (T4) değerleri
çalışıldı. Gerekli görülen hastalarda Anti tirodidperoksidaz
(Anti-TPO), Anti tiroglobulin (Anti-Tg) parametrelerine
bakıldı. Olgularda tiroid fonksiyonlarının eklampsi, preeklampsi,
maternal anemi, postpartum kanama, fetal anomali,
omuz distosisi, yenidoğan hipoglisemisi gibi komplikasyonlarla
ilişkisi araştırıldı.
Bulgular: Olguların 18 ’inde hipotiroidi, 4 ‘ünde hipertiroidi
tespit edildi. Çalışmaya dahil edilen olguların yaş
ortalaması 26.42 (± 8.42) olarak bulundu. Ortalama TSH
değeri 1.86 ± 0.19 μIU/mL, serbest T4 1.15 ± 0.29 ng/mL,
serbest T3 2.90 ± 0.31 pg/mL olarak saptandı. Hipotiroidi
tanısı alan hastalar değerlendirildiğinde etiyolojide Hashimoto
tiroiditi (9 olgu, %50 ), en sık neden olarak bulundu.
Diğer etiyolojik faktörler ise, 4 olguda (%22.2) iatrojenik
(daha önceden tiroidektomi geçirmiş) ve 5 olguda (%37.8)
iyot eksikliği olarak tespit edildi. Hipotiroidili olgulardan
5 ‘inde (%27.78) maternal anemi gözlendi. Preeklampsi,
hipotiroidili olgularda %16.67 oranında gözlendi.
Sonuç: Gebelerde gözlenen tiroid fonksiyon bozuklukları
maternal ve fetal ciddi komplikasyonlar meydana getirebilir.
Gebelikte oluşabilecek tiroid fonksiyon bozukluklarında
uygun zamanda gerekli tedavinin sağlanması anne
ve fetusda oluşabilecek komplikasyonların önlenmesi açısından önemlidir.

Kaynakça

  • American College of Obstetrics and Gynecology.ACOG practice bulletin. Thyroid disease in pregnancy. Number 37, August 2002. American College of Obstetrics and Gynecology.Int J Gynaecol Obstet 2002;79(2):171-80.
  • Glinoer D, de Nayer P, Bourdoux P, Lemone M, Robyn C, van Steirteghem A, Kinthaert J, Lejeune B.Regulation of maternal thyroid during pregnancy.J Clin Endocrinol Metab 1990;71(2):276-87.
  • Ain KB, Mori Y, Refetoff S. Reduced clearance rate of thyroxinebinding globulin (TBG) with increased sialylation: A mechanism for estrogen-induced elevation of serum TBG concentration. J Clin Endocrinol Metab 1987;65(4):68996.
  • Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 1997;18(3):404-33.
  • Brent GA. Maternal hypothyroidism: recognition and management. Thyroid 1999;9(7):661-5.
  • Brent GA. Maternal thyroid functions: interpretation of thyroid function tests in pregnancy. Clin Obstet Gynecol 1997;40(1):3-15.
  • Pop VJ, Kuijpens JL, Van Baar AL, et al. Low maternal free thyroxine concentrations during early pregnacy are associated with impaired psychomotor development in early infancy. Clin Endocrinol (Oxf) 1999;50(2):149-55.
  • Andersen S, Bruun NH, Pedersen KM, Laurberg P. Biologic variation is important for interpretation of thyroid function tests. Thyroid 2003;13(11):1069-78.
  • Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A, Mitchell ML. Prevalance of thyroid defiency in pregnant women. Clin Endocrinol (Oxf) 1991;35(1):41-6.
  • Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, Cunningham FG. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005;105(2):239-45.
  • Casey BM. Subclinical hypothyoridism and pregnancy. Obstet Gynecol Surv 2006;61(6):415-20;.
  • Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999;341(8):549-55.
  • Pop VJ, Brouwers EP, Vader HL, Vulsma T, van Baar AL, de Vijlder JJ. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol (Oxf) 2003;59(3):282-8.
  • Burrow GN. The management of thyrotoxicosis in pregnancy. N Engl J Med 1985;313(9):562-5.
  • Neale D, Burrow G. Thyroid disease in pregnancy. Obstet Gynecol Clin North Am 2004;31(4):893-905.
  • Ecker JC, Musci TJ. Thyriod function and disease in pregnancy. Curr Prob Obstet Gynecol Fertil 2000; 23(1): 10922.
  • Glinoer D. Management of hypo-and hyperthyroidism during pregnancy. Growth Horm IGF Res 2003;13 Suppl A:S45-54.
  • Lazarus JH. Thyroid dysfunction: reproduction and postpartum thyroiditis. Semin Reprod Med 2002;20(4):381-8.
  • Wasserstrum N, Anania CA. Perinatal consequences of maternal hypothyroidism in early pregnancy and inadequate replacement Clin Endocrinol (Oxf) 1995;42(4):353-8.
  • Lowell ED, Kenneth JL, Cunningham FG. Hypothyroidism complicating pregnancy Obstet Gynecol 1988;72(1):10812.
  • Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ, Faix JD, Klein RZ. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen 2000;7(3):127-30.
  • Glinoer D, De Nayer P, Delange F, et al. A randomized trial for the treatment of mild iodine deficiency during pregnancy: Maternal and neonatal effects. J Clin Endocrinol Metab 1995;80(1):258-69.
  • Mestman JH. Hyperthyroidism in pregnancy. Best Pract Res Clin Endocrinol Metab. 2004;18(2):267-88.
  • Susan J, Mandel SC, David SC. The use of antithyroid drugs in pregnancy and lactation. J Clin Endocrinol Metab 2001;86(6):2354-9.
  • Nader S. Thyroid disease and other endocrine diseasenin pregnancy. Obstet Gynecol Clin North Am 2004;31(2):25785.
  • Girling JC. Thyroid disorders in pregnancy. Curr Obstet Gynaecol 2003;13 (1):45-51.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Yazısı
Yazarlar

Mehmet Sühha Bostancı Bu kişi benim

Fatih Taşkesen Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2011
Yayımlandığı Sayı Yıl 2011

Kaynak Göster

APA Bostancı, M. S., & Taşkesen, F. (2011). Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi. Journal of Clinical and Experimental Investigations, 2(2), 196-201. https://doi.org/10.5799/ahinjs.01.2011.02.0238
AMA Bostancı MS, Taşkesen F. Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi. J Clin Exp Invest. Haziran 2011;2(2):196-201. doi:10.5799/ahinjs.01.2011.02.0238
Chicago Bostancı, Mehmet Sühha, ve Fatih Taşkesen. “Gebelikte Tiroid Fonksiyon Bozuklukları Ve sonuçlarının değerlendirilmesi”. Journal of Clinical and Experimental Investigations 2, sy. 2 (Haziran 2011): 196-201. https://doi.org/10.5799/ahinjs.01.2011.02.0238.
EndNote Bostancı MS, Taşkesen F (01 Haziran 2011) Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi. Journal of Clinical and Experimental Investigations 2 2 196–201.
IEEE M. S. Bostancı ve F. Taşkesen, “Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi”, J Clin Exp Invest, c. 2, sy. 2, ss. 196–201, 2011, doi: 10.5799/ahinjs.01.2011.02.0238.
ISNAD Bostancı, Mehmet Sühha - Taşkesen, Fatih. “Gebelikte Tiroid Fonksiyon Bozuklukları Ve sonuçlarının değerlendirilmesi”. Journal of Clinical and Experimental Investigations 2/2 (Haziran 2011), 196-201. https://doi.org/10.5799/ahinjs.01.2011.02.0238.
JAMA Bostancı MS, Taşkesen F. Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi. J Clin Exp Invest. 2011;2:196–201.
MLA Bostancı, Mehmet Sühha ve Fatih Taşkesen. “Gebelikte Tiroid Fonksiyon Bozuklukları Ve sonuçlarının değerlendirilmesi”. Journal of Clinical and Experimental Investigations, c. 2, sy. 2, 2011, ss. 196-01, doi:10.5799/ahinjs.01.2011.02.0238.
Vancouver Bostancı MS, Taşkesen F. Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi. J Clin Exp Invest. 2011;2(2):196-201.