Endocrine Abstracts

In Bulgaria there are epidemiological data for the population of 20–80 years for the frequency of thyroid dysfunction – 6.3% hypothyroidism and 3.7% hyperthyroidism (Bulgarian Society of Endocrinology, 2012). So far, there is no national data on the incidence of thyroid disorders in pregnant women, which is a major lack of the health care system and the purpose of this study is to fill this gap.

Material and Methods: We studied 547 pregnant Bulgarian women from 10 regions of the country, with mean age 30 ± 5 y. The prevalence of subclinical (SHT), overt (OHT) hypothyroidism, subclinical (SHyperT), overt (OHyperT) hyperthyroidism was determined. TSH, FT4 were measured and ultrasound of thyroid was performed.

Results: Screening find in 20.1% of pregnant women (n-110) SHT, 6.2% (n-34) OHT, 0.9% (n-5) SHyperT and 0.4% (n-2) OHyperT. In 79 (55%) pregnant women hypothyroidism has been known and has been treated – 76 with SHT and 3 – with OHT. There are 65 (45%) pregnant women with newly discovered hypothyroidism – 34 with SHT and 31 with OHT. Thus, of all 144 pregnant women with hypothyroidism, only 55 (38.2%) under the Levothyroxine treatment achieved an euthyroid state, but the remaining 89 (61%) were hypothyroid (55 with SHT and 34 with OHT), although some were under hormonal treatment. During pregnancy, the proportion of women undergoing treatment with Levothyroxine increased: I trimester – 42%, II trimester – 45%, III trimester – 57%.

Conclusion: The presence of 16.3% of hypothyroid pregnant women (89 of the 547 studied) is a poor certificate for maternal and child health care. In the presence of verbally established risk factors for thyroid disease early diagnosis, timely inclusion of an adequate dose of Levothyroxine and regular monitoring are needed.