Endocrine Abstracts

After diabetes, thyroid disorder is the second most common endocrine disorder in women of reproductive age. Thyroid disorders in pregnancy have been proven to have adverse maternal and foetal outcome if not treated adequately and timely.

Aim: The aim of this audit was to assess management and therapeutic interventions and outcomes of pregnancies complicated by thyroid disorders.

Method: A retrospective case notes analysis of 35 pregnancies with thyroid disorders booked in antenatal clinic at Good Hope Hospital, Sutton Coldfield in 1996 was performed. Parameters included were prepregnancy counselling, thyroid function tests assessment, change in treatment instituted, outcome of pregnancy. Standard laboratory non-pregnant reference ranges were used for thyroid function test interpretation in all three trimesters.

Result: Of 35 pregnancy 32 (91%) had hypothyroidism and 3 (9%) had hyperthyroidism. Prepregnancy counselling was provided to 13% of pregnant women with thyroid disorders. In hypothyroid group medication increased in 21% and decreased in 3%. In hyperthyroid group, Propylthiouracil started in 2 (66%) and decreased and stopped in 2 (66%).

Conclusion: With appropriate and timely adjustment in therapy majority of pregnancy had good outcome. Usually in pregnancy with hypothyroidism, the dose of levothyroxine needs increasing but in one of our pregnant woman it was decreased. We need consensus on reference range for interpretation of thyroid function test in different trimesters of pregnancy.