Subklinik hipotiroidinin gebelik üzerine olumsuz etkisi var mı? tüm gebelere tarama yapmak gerekir mi?

Amaç: Subklinik Hipotiroidinin gebelik ve fetüs üzerinde etkilerini araştırmak. Gereçler ve Yöntem: Çalışmaya Ocak 2002 - Haziran 2006 tarihleri arasında Akdeniz Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde takip edilen ve klinikte doğum yapmış olan gebeler alındı. Doğum kayıtlarında 20. gebelik haftasından sonra doğum yapmış olan gebelerin kayıtları inceledi. Gebeler tiroid fonksiyon testlerine (TFT) göre subklinik hipotiroidi olanlar hasta grubuna ve normal TFT olanlar arasından kontrol grubu seçildi. Hasta grubundan 24 ve kontrol grubundan 48 gebe çalışmaya alındı. Gruplar gebelik komplikasyonu olan gestasyonel hipertansiyon, preeklampsi, eklampsi, preterm eylem, intrauterin ölüm, intrauterin gelişme geriliği ve ablasyo plasenta yönünden; yeni doğanları doğum haftası, doğum ağırlığı, 5. dakika Apgar skoru, neonatal ölüm, doğum sonrası yeni doğan yoğun bakım desteği alma, majör malformasyon, respiratuvar distress sendromu, nekrotizan enterokolit, intraventriküler kanama komplikayonu gelişmesi yönünden karşılaştırıldı. Bulgular: Araştırma sonucunda iki grup arasında gebelik ve yenidoğan komplikasyonları yönünden fark gözlenmedi. Sonuç: Subklinik hipotiroidinin gebelik seyri ve fetüs üzerine olumsuz etkisinin olup olmadığı henüz açıklığa kavuşmamış bir konudur. Yakın zamanda yapılan çakışmalarda subklinik hipotiroidinin gebelik seyri ve fetüs üzerine olumsuz etkisinin olduğu bildirilmektedir. Bizim çalışmamızda olumsuz etki gözlenmemiş olması hasta sayısının az olmasından kaynaklanıyor olabilir.

Is there any adverse effect of subclinical hypothyroidism on pregnancy outcome? screening of all pregnant women: Is it necessary?

Aim: To investigate the effect of the subclinical hypothyroidism on pregnancy and fetus . Materials and Method: In this study, we include the pregnant women who been followed up at Mediterrenean University Department of Obstetrics & Gynecology Antenatal Clinics between January 2002 and June 2006. We analyzed the data of the pregnants who delivered after 20th gestational week. We divided the pregnant patients into two groups having :normal thyroid hormon test results and subclinical thyroid disease. After analyzing the patient data, we included 24 pregnant women as the patient group and 48 pregnant women as controls. The pregnants were searched for gestational hypertension, preeclampsia, eclampsia, preterm delivery, intrauterine death, intrauterine growth retardation and ablatio placentae. The neonates were searched for gestational age at birth, birthweight, 5t minute Apgar score, neonatal death, neonatal intensive care admission, major malformation, respiratory distress syndrome, necrotizing enterocolitis, intraventricular bleeding. Result: There was no difference between both groups in respect of the pregnancy complications and neonatal complications. Conclusion: Subclinical hypothyroidism had been reported to have adverse effects on pregnancy and fetus; however, due to small sampling size, we were unable to reach a definite conclusion.

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