Subclinical thyrotoxicosis or transient hypothyreotropinemia of pregnants?

Close metadata

Recommended articles:

Cytokines in normal pregnancy and miscarriage. Russian Journal of Human Reproduction. 2024;(1):72-81

The course of pregnancy and its outcomes in women who have suffered COVID-19. Russian Journal of Human Reproduction. 2024;(1):92-99

The effect of various surgical techniques in myomectomy on reproductive outcomes (A review). Russian Journal of Human Reproduction. 2024;(1):109-115

Hemorrhagic stroke during pregnancy as a result of rupture of cavernous malformation. Clinical case. Russian Journal of Human Reproduction. 2024;(2):90-95

Justification of systemic antibacterial therapy in patients with subclinical intrauterine infection during pregnancy. Russian Bulletin of Obstetrician-Gynecologist. 2024;(2):62-67

Adverse perinatal outcomes in COVID-19. Analysis of a series of clinical observations. Russian Bulletin of Obstetrician-Gynecologist. 2024;(2):86-90

The problem of venous thromboembolic complications prevention in the realities of modern obstetrics. Russian Bulletin of Obstetrician-Gynecologist. 2024;(2):104-111

Peculiarities of local mRNA gene expression of pro- and anti-inflammatory cytokines in term pregnancy. Russian Bulletin of Obstetrician-Gynecologist. 2024;(3):6-13

The problem of diabetes mellitus in obstetrics. Russian Bulletin of Obstetrician-Gynecologist. 2024;(3):25-29

Relationship between pregnancy and the risk of malignant neoplasms of the female reproductive system. Russian Bulletin of Obstetrician-Gynecologist. 2024;(3):48-54

Objective — to assess the compliance of a decrease in TSH in the first trimester of pregnancy with thyrotoxicosis syndrome. Material and methods. 92 pregnant women with diagnosed thyrotoxicosis without goiter and the presence of antibodies to tyroperoxidase participated in the cohort study. Pregnant women divided into two groups: with manifest thyrotoxicosis (n=38) and subclinical thyrotoxicosis (n=54). In the first group, clinical symptoms corresponding to thyrotoxicosis syndrome observed. In the second group, no clinical manifestations of thyrotoxicosis observed. Half of the pregnant women of the first group canceled with potassium iodide, the second half of the group continued to take potassium iodide. Against the background of cancellation of potassium iodide, severe hypothyroxinemia with relatively low TSH was observed, while in pregnant women who did not cancel potassium iodide, the thyroid status remained within the reference range. Discussion. The concept of «subclinical thyrotoxicosis» in pregnant women does not correspond to the presence of thyrotoxicosis syndrome, since HCG progressively increasing in the first trimester of pregnancy, performs the function of TSH. This situation should be regarded as a functional transient hypothyreotropinemia, which is the physiological state of pregnancy. Conclusion. Do not discontinue potassium iodide when hypothyrotropinemia in pregnant women; pregnancy management is carried out as physiological, according to the standards of pregnancy management.

Keywords:

thyrotoxicosis

pregnant

chorionic gonadotropin

TTG

hypothyroxinemia

hypothyrotropinemia

Authors:

Yakubova E.G.

Department of Obstetrics, gynecology and resuscitation with a course of laboratory diagnostics of Institute of CPD of the Federal State Budgetary Institution of Higher Education;
State Budgetary Institution of Health Care 'Perinatal Center', Tyumen, Russia

Kukarskaya I.I.

List of references:

Dedov II, Bezlepkina OB, Vadina TA, Baibarina EN, Chumakova OV, Karavaeva LV, Bezlepkin AS, Peterkova VA. Screening for congenital hypothyroidism in the Russian Federation. Problemy Endokrinologii. 2018;64(1):14-20. (In Russ.) https://doi.org/10.14341/probl201864114-20
Diagnosis and treatment of thyroid diseases during pregnancy in the postpartum period: based on the clinical recommendations of the endocrinological Association of the United States. Klinicheskaya i eksperimental’naya tireodologiya. 2006;2(4):15-20. (In Russ.)
Sviridonova MA. Iodine Deficiency and Human Development. Klinicheskaya i eksperimental’naya tireodologiya. 2014;10(1):9-20. (In Russ.) https://doi.org/10.14341/cet20141019-20
Fadeyev VV. Guidelines of the American Thyroid Association for the Diagnosisand Management of Thyroid Disease During Pregnancy and Postpartum. Klinicheskaya i eksperimental’naya tireodologiya. 2012;8(1):7-18. (In Russ.)
Cunha N, Gomes L, Cardoso L, Vicente N, Martins D, Oliveira D, Lages A, Ventura M, Lemos M, Carrilho F. Innapropriate TSH secretion: the challenging diagnosis. Problemy endokrinologii. 2016;62(5):79-80. (In Russ.) https://doi.org/10.14341/probl201662579-80
Spencer L, Bubner T, Bain E, Middleton P. Screening and subsequent management for thyroid dysfunction pre-pregnancy and during pregnancy for improving maternal and infant health. The Cochrane Database of Systematic Reviews. 2015;9:CD011263. https://doi.org/10.1002/14651858.CD011263.pub2
Troshina EA, Sviridenko NYu, Vanushko VE, Rumyantsev PO, Fadeev VV, Petunina NA. The federal clinical recommendations on diagnostics and treatment of toxic goiter. Problemy Endokrinologii. 2014;60(6):67-77. (In Russ.)
National Endocrine and Metabolic Diseases Information Service. Pregnancy and Thyroid Disease. April 2012. NIH Publication 12-6234.
Endokrinologiya. Nacional’noe rukovodstvo. Pod red. Dedova I.I., Mel’nichenko G.A. M.: GEOTAR-Media; 2014. (In Russ.)
Ametov AS, Kondrat’eva LV, Bugova LA. Graves‘ disease and functional thyroid autonomy in a region with mild iodine deficiency. Klinicheskaya i eksperimental’naya tireodologiya. 2011;7(4):51-55. (In Russ.)
Petunina NA, Martirosyan NS, Trukhina LV. Thyroid dysfunction and hematopoietic system. Klinicheskaya i eksperimental’naya tireodologiya. 2011;7(4):27-31. (In Russ.)
Dogadin CA, Dudina MA, Savchenko AA, Mankovsky VA, Gvozdev II. Activity of respiratory explosion of blood neutrophils in the debut of Graves’ disease. Problemy Endokrinologii. 2017;63(1):4-8. (In Russ.)
Troshina EA, Platonova NM, Abdulhabirova FM, Gerasimov GA. Jododeficitnye zabolevaniya v Rossijskoj Federacii: vremya prinyatiya reshenij. Pod red. Dedova I.I., Mel’nichenko G.A. M.: Konti print; 2012. (In Russ.)
Troshina EA, Platonova NM, Panfilova EA, Panfilov KO. Analytical review of the results of monitoring the main epidemiological characteristics of iodine deficiency diseases in the population of the Russian Federation for the period 2009—2015. Problemy endokrinologii. 2018;64(1):21-37. (In Russ.)
Mazurina NV, Troshina EA, Suhacheva OS. Differential diagnosis of autoimmune hyperthyroidism and the syndrome of resistance to thyroid hormone: clinical case description. Problemy endokrinologii. 2019;65(2):95-100. (In Russ.)
Isaeva MA, Bogatyreva ZI, Suchkova EN, Tsaguria KG, Antsiferov MB, Paltsev MA, Suchkov SV. Autoantibodies of different levels of specificity and functionality in the pathogenesis and diagnosis of autoimmune thyroid diseases. Klinicheskaya i eksperimental’naya tireodologiya. 2007;3(4):27-34. (In Russ.)
Koroleva DN, Olina TS, Kovalenko TV. HCG-secreting hepatoblastoma. Problemy Endokrinologii. 2017;63(2):127-129. (In Russ.) https://doi.org/10.14341/probl2017632127-129
Earl R, Crowther CA, Middleton P. Interventions for hyperthyroidism pre-pregnancy and during pregnancy. The Cochrane Database of Systematic Reviews. 2013;11:CD008633. https://doi.org/10.1002/14651858.CD008633.pub3
Sviridonova MA, Ilyin AV, Kolesnikova GS, Fadeev VV. Klinicheskaya i eksperimental’naya tireodologiya. 2009;5(2):30-33. (In Russ.)
Yango J, Alexopoulou O, Eeckhoudt S, Hermans C, Daumerie C. Evaluation of the respective influence of thyroid hormones and TSH on blood coag ulation parameters after total thyroidectomy. European Journal of Endocrinology. 2011;164(4):599-603.

Close metadata