Gebelikte tiroid fonksiyon bozuklukları ve sonuçlarının değerlendirilmesi

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. Klin Deney Ar Derg 2011;2(2):196-201

Thyroid dysfunction during pregnancy and evaluation of its results

Objectives: In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women. Materials and methos: 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. J Clin Exp Invest 2011;2(2):196-201

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