The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Plekhanova M.A.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Shidlovskaya N.V.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Burumkulova F.F.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Kapustina M.V.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Bashakin N.F.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Vaganova E.I.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Kovalenko A.A.

I.M. Sechenov First Moscow State Medical University

Problems of pregnancy planning and gestation in patients with diffuse toxic goiter after radiotherapy

Authors:

Plekhanova M.A., Shidlovskaya N.V., Burumkulova F.F., Kapustina M.V., Bashakin N.F., Vaganova E.I., Kovalenko A.A.

More about the authors

Journal: Russian Bulletin of Obstetrician-Gynecologist. 2025;25(1): 82‑87

DOI: 10.17116/rosakush20252501182

Views: 377

Downloaded: 5

Buy for 300₽
Contact the author
Table of contents

PROBLEMS OF PREGNANCY PLANNING AND GESTATION IN PATIENTS WITH DIFFUSE TOXIC GOITER AFTER RADIOTHERAPY
PROBLEMS OF PREGNANCY PLANNING AND GESTATION IN PATIENTS WITH DIFFUSE TOXIC GOITER AFTER RADIOTHERAPY

To cite this article:

Plekhanova MA, Shidlovskaya NV, Burumkulova FF, Kapustina MV, Bashakin NF, Vaganova EI, Kovalenko AA. Problems of pregnancy planning and gestation in patients with diffuse toxic goiter after radiotherapy. Russian Bulletin of Obstetrician-Gynecologist. 2025;25(1):82‑87. (In Russ.)
https://doi.org/10.17116/rosakush20252501182

Подписка 2025-2 (Russian Bulletin of Obstetrician-Gynecologist)
 
МСФ на ЯМ
Close metadata
Recommended articles:
Dacryocystorhinostomy with a counteropening in the treatment of seco­ndary naso­lacrimal duct obstruction after radioiodine therapy. Russian Annals of Ophthalmology. 2024;(2-2):60-67
The Russian consensus on the treatment of intrahepatic cholangiocarcinoma. Piro­gov Russian Journal of Surgery. 2024;(10):7-20
Choice of fractionation regi­men for Grade IV gliomas depe­nding on rapid early progression. Burdenko's Journal of Neurosurgery. 2024;(5):23-29
Disease-free survival after surgical and combined treatment of newly diagnosed craniopharyngiomas in adults. Burdenko's Journal of Neurosurgery. 2024;(5):54-59
Simu­ltaneous thyroidectomy for follicular adenocarcinoma and subclavian-carotid prosthetics. P.A. Herzen Journal of Onco­logy. 2024;(5):59-61

Diffuse toxic goiter (DTG) is the most common cause of thyrotoxicosis during pregnancy, which is associated with a high risk of obstetric and perinatal complications. Self-induced abortion, preeclampsia and premature birth are more common in pregnant women with poorly compensated DTG, and thyrotoxic crisis is the main cause of maternal mortality. The drug of choice for the treatment of DTG during pregnancy is propylthiouracil, and from the second trimester and during lactation, thiamazole. Radiotherapy is one of the most effective, safe and frequently used methods of treatment for DTG, but only in non-pregnant women. Metabolites of 131I freely penetrate the placenta and there is a risk of destruction of the thyroid gland of the fetus. The use of radiotherapy in women of childbearing age is possible only after assessing the level of chorionic gonadotropin 72 hours before the start of such treatment, and pregnancy planning is possible only after achieving persistent euthyroidism, and not earlier than 6 months after radiotherapy. Deviation from the established recommendations can lead to adverse outcomes, which is suggested in our clinical observation.

Keywords:

thyrotoxicosis of pregnant women
thyroidectomy
radiotherapy

Authors:

Plekhanova M.A.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Shidlovskaya N.V.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Burumkulova F.F.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Kapustina M.V.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Bashakin N.F.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Vaganova E.I.

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

Kovalenko A.A.

I.M. Sechenov First Moscow State Medical University

Received:

14.05.2024

Accepted:

13.06.2024

List of references:

  1. Laurberg P, Andersen SL. Endocrinology in pregnancy: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease. Eur J Endocrinol. 2016;175:5:R219-30. 
  2. Dulek H, Vural F, Aka N, Zengin S. The prevalence of thyroid dysfunction and relationship with perinatal outcomes in the third trimester. North Clin Istanb. 2019;6:3:267-272.  https://doi.org/10.14744/nci.2018.51422
  3. Abdullah AA, Ramli N, Yaacob NM, Hussain S. Neonatal Outcomes of pregnancies complicated by maternal hyperthyroidism. J ASEAN Fed Endocr Soc. 2022;37:2:15-22.  https://doi.org/10.15605/jafes.037.02.03
  4. Besançon A, Beltrand J, Le Gac I, Luton D, Polak M. Management of neonates born to women with Graves’ disease: a cohort study. Eur J Endocrinol. 2014;170:6:855-862.  https://doi.org/10.1530/EJE-13-0994
  5. Léger J. Management of fetal and neonatal graves’ disease. Horm Res Paediatr. 2017;87:1:1-6.  https://doi.org/10.1159/000453065
  6. Glinoer D. Management of hypo- and hyperthyroidism during pregnancy. Growth Horm IGF Res. 2003;13 Suppl A:S45-54.  https://doi.org/10.1016/s1096-6374(03)00055-8
  7. Troshina EA, Sviridenko NYu, Vanushko VE, Rumyantsev PO, Fadeev VV, Petunina NA. Federal clinical guidelines for the diagnosis and treatment of toxic goiter. Problemy endokrinologii. 2014;60:6:67-77. (In Russ.). https://doi.org/10.14341/probl201460667-77
  8. Li C, Zhou J, Huang Z, Pan X, Leung W, Chen L, Guan L, Zhang Y, Wang, L, Sima Y, Gober H, Zhang N, Qiu X, Li L, Guan L, Wang L. The clinical value and variation of antithyroid antibodies during pregnancy. Dis Markers. 2020;2020:8871951. https://doi.org/10.1155/2020/8871951
  9. Chapman AK, Farmer ZJ, Mastrandrea LD, Matlock KA. Neonatal thyroid function and disorders. Clin Obstet Gynecol. 2019;62:2:373-387.  https://doi.org/10.1097/GRF.0000000000000434
  10. Papendieck P, Chiesa A, Prieto L, Gruñeiro-Papendieck L. Thyroid disorders of neonates born to mothers with Graves’ disease. J Pediatr Endocrinol Metab. 2009;22:6:547-553.  https://doi.org/10.1515/jpem.2009.22.6.547
  11. van der Kaay DC, Wasserman JD, Palmert MR. Management of neonates born to mothers with graves’ disease. Pediatrics. 2016; 137:4:e20151878. https://doi.org/10.1542/peds.2015-1878
  12. Abeillon-du Payrat J, Chikh K, Bossard N, Bretones P, Gaucherand P, Claris O, Charrié A, Raverot V, Orgiazzi J, Borson-Chazot F, Bournaud C. Predictive value of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism. Eur J Endocrinol. 2014;171:4:451-460.  https://doi.org/10.1530/EJE-14-0254
  13. Ogilvy-Stuart AL. Neonatal thyroid disorders. Arch Dis Child Fetal Neonatal Ed. 2002;87:3:F165-71.  https://doi.org/10.1136/fn.87.3.f165
  14. Myrthe M. van Dijk, Iris H. Smits, Eric Fliers, and Peter H. Bisschop. Maternal thyrotropin receptor antibody concentration and the risk of fetal and neonatal thyrotoxicosis: A Systematic review. Thyroid Feb. 2018;257-264. 
  15. Polak M, Le Gac I, Vuillard E, Guibourdenche J, Leger J, Toubert M-E, Madec A-M, Oury J-F, Czernichow P, Luton D. Fetal and neonatal thyroid function in relation to maternal Graves’ disease. Best Pract Res Clin Endocrinol Metab. 2004;18:2:289-302. 
  16. Pediatric newborn medicine clinical practice guidelines identification and screening of neonates born to mothers with a history of thyroid dysfunction 2020 11 c.  https://www.brighamandwomens.org/assets/BWH/pediatric-newborn-medicine/pdfs/maternal-thyroid-disfunction.pdf
  17. Bruner JP, Dellinger EH. Antenatal diagnosis and treatment of fetal hypothyroidism. A report of two cases. Fetal Diagn Ther. 1997; 12:4:200-204.  https://doi.org/10.1159/000264468
  18. Batra CM. Fetal and neonatal thyrotoxicosis. Indian J Endocrinol Metab. 2013;17:Suppl 1:S50-54.  https://doi.org/10.4103/2230-8210.119505
  19. Kurtoğlu S, Özdemir A. Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment. Turk Pediatri Ars. 2017;52:1:1-9.  https://doi.org/10.5152/TurkPediatriArs.2017.2513
  20. Wang HI, Yiang GT, Hsu CW, Wang JC, Lee CH, Chen YL. Thyroid storm in a patient with trauma — A Challenging diagnosis for the emergency physician: Case report and literature review. J Emerg Med. 2017;52:3:292-298.  https://doi.org/10.1016/j.jemermed.2016.09.003
  21. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22:2:263-277. 
  22. Kitazawa C, Aoki S, Takahashi T, Hirahara F. Acute respiratory failure due to thyroid storm developing immediately after delivery. Clin Case Rep. 2015;3:12:997-999.  https://doi.org/10.1002/ccr3.422
  23. Marx H, Amin P, Lazarus JH. Hyperthyroidism and pregnancy. BMJ. 2008;336:7645:663-667.  https://doi.org/10.1136/bmj.39462.709005.AE
  24. Luewan S, Chakkabut P, Tongsong T. Outcomes of pregnancy complicated with hyperthyroidism: a cohort study. Arch Gynecol Obstet. 2011;283:2:243-247.  https://doi.org/10.1007/s00404-010-1362-z
  25. Shidlovskaya NV, Logutova LS, Petrukhin VA, Burumkulova FF, Bashakin NF. Features of the course of pregnancy, drug therapy and perinatal outcomes in diffuse toxic goiter. Rossiiskii vestnik akushera-ginekologa. 2008;8:4:9-16. (In Russ.).
  26. Iagaru A, McDougall IR. Treatment of thyrotoxicosis. J Nucl Med. 2007;48:3:379-389. Erratum in: J Nucl Med. 2007 Jun;48(6):872.
  27. Berg GE, Michanek AM, Holmberg EC, Fink M. Iodine-131 treatment of hyperthyroidism: significance of effective half-life measurements. J Nucl Med. 1996;37:2:228-232. 
  28. Stoffer SS, Hamburger JI. Inadvertent 131I therapy for hyperthyroidism in the first trimester of pregnancy. J Nucl Med. 1976; 17:02:146-149. 
  29. Manual on Contrast Media. Version 6 ed. Reston, Va: American College of Radiology; 2008. https://www.arinursing.org/ARIN/assets/File/public/practice-guidelines/l_Contrast_Extravasation.pdf
  30. Meier DA, Brill DR, Becker DV, Clarke SE, Silberstein EB, Royal HD, Balon HR; Society of Nuclear Medicine. Procedure guideline for therapy of thyroid disease with (131)iodine. J Nucl Med. 2002;43:6:856-861. 
  31. Fang Y, Du WH, Zhang CX, Zhao SX, Song HD, Gao GQ, Dong M. The effect of radioiodine treatment on the characteristics of TRAb in Graves’ disease. BMC Endocr Disord. 2021;21:1:238.  https://doi.org/10.1186/s12902-021-00905-4
  32. Ma Y, Li H, Liu J, Lin X, Liu H. Impending thyroid storm in a pregnant woman with undiagnosed hyperthyroidism: A case report and literature review. Medicine (Baltimore). 2018;97:3:e9606. https://doi.org/10.1097/MD.0000000000009606
  33. Szumowski P, Abdelrazek S, Kociura Sawicka A, Mojsak M, Kostecki J, Sykała M, Myśliwiec J. Radioiodine therapy for Graves’ disease — retrospective analysis of efficacy factors. Endokrynol Pol. 2015;66:2:126-131.  https://doi.org/10.5603/EP.2015.0019
  34. Huel C, Guibourdenche J, Vuillard E, Ouahba J, Piketty M, Oury JF, Luton D. Use of ultrasound to distinguish between fetal hyperthyroidism and hypothyroidism on discovery of a goiter. Ultrasound Obstet Gynecol. 2009;33:4:412-420.  https://doi.org/10.1002/uog.6315
  35. Singh PK, Parvin CA, Gronowski AM. Establishment of reference intervals for markers of fetal thyroid status in amniotic fluid. J Clin Endocrinol Metab. 2003;88:9:4175-4179. https://doi.org/10.1210/jc.2003-030522
  36. Duncombe GJ, Dickinson JE. Fetal thyrotoxicosis after maternal thyroidectomy. Aust N Z J Obstet Gynaecol. 2001;41:2:224-227.  https://doi.org/10.1111/j.1479-828x.2001.tb01215.x
  37. Reynolds BC, Simpson JH, Macara L, Watt AJ, Kubba H, Donaldson MD, Pohlen J. Goitrous congenital hypothyroidism in a twin pregnancy causing respiratory obstruction at birth: implications for management. Acta Paediatr. 2006;95:11:1345-1348. https://doi.org/10.1080/08035250600711074

Close metadata

Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.