Endocrine Abstracts

Background: Hypothyroidism occurs in 2.5% of pregnancies. We are using a database follow up system for pregnant women with hypothyroidism in our hospital. All the women with hypothyroidism are added on a database system at their first visit to the antenatal clinic. Any adjustment to thyroxine was made on the first visit after checking TFT and repeat TFTs were done at 20 and 30-weeks gestation. Any adjustments to thyroxine were communicated to them via letter. The aim of this study was to evaluate the effectiveness of this system in a district general hospital setting.

Methods: A total of 76 pregnant women with hypothyroidism were seen in the combined antenatal clinic from June 2007 until November 2008. Sixty-three patients were entered on the database system and did not attend the clinic further. Thirteen patients were followed up in the clinic for obstetric reasons.

Results: About 44/63 patients added on database had full sets of TFT (at 20 and 30 week gestation) done 16 patients had only 1 set of TFT while 3 patients had no results recorded. About 33/63 patients had some adjustment in their thyroxine dose (28 at first visit, 1 each after 2nd and 3rd TFT check and 3 at first visit and then 2nd TFT check); 27 had no adjustment and 3 patients remained without treatment. Out of 13 patients attending the clinic regularly, 11 had full sets of TFTS while 2 have only 1 TFT recorded. About 8/13 patients needed any dose adjustment to there thyroxine with 2 patients each after 1st and 2nd TFT checked, 2 patients each needing adjustment after both 1st and 2nd TFT checked and 2nd and 3rd TFT checked and 1 patient needing adjustment after all 3 TFTs.

Conclusion: A database follow-up system for pregnant hypothyroid women is practical in a district general hospital setting.