Endocrine Abstracts

Introduction: -Thyroid disorders can predate or develop during pregnancy. -The effects on the fetus vary depending on the disease and the drugs used for treatment. But usually, untreated or undertreated hyperthyroidism can lead to harmful complications.

Case report: It’s a 26-year-old patient with a history of goiter since childhood, history of goiter in the mother; grandmother and maternal aunt. the patient is 18 weeks pregnant, the pregnancy is unplanned. Anamnesis:the notion of weight loss; palpitation and dyspnea The clinical examination revealed a: goiter Grade 3 with turgidity in the jugular veins. Investigations showed: white blood cell 11440/mm3 Neutrophil : 6115/mm3 Hemoglobin:12.7 g/100ml blood platelets : 19400/mm3 ALAT : 10 UI/I ASAT:19 UI/I TSH:0.005uUI/ml T4:16;6 pmol/l T3:7,2 pmol/l On cervical ultrasound: nodular goiter classified EU TIRADs 3; the largest measuring on the right 42*32 mm and on the left 23*21mm Patient was started synthetic antithyroid drug and she was sent to surgery after euthyroidism.

Discussion: The association of thyroid disease and pregnancy is relatively common [1-4]. The increase in thyroid volume during pregnancy has been known since antiquity. In fact, pregnancy is favored by the increase in the need for thyroid hormones, and the hormonal variations that accompany it, an increase in the functional activity of the thyroid gland, and the nodular remodeling of goiters, and potentially the growth of possible nodules. cancer [2,3]. Thyroid surgery, in the event of pregnancy, is indicated in cases involving the vital prognosis of the mother and/or fetus (bulky goiters compressing the esophagus or the trachea, a state of hyperthyroidism difficult to balance such as the case of of Basedow) at any time, preferably during the second trimester to avoid first-trimester abortion and third-trimester preterm delivery [1,4]. It is also indicated during pregnancy for medullary carcinoma [4].

Conclusion: Pregnancy is a test for the thyroid gland. The latter has significant adaptive capacities which allow it on the whole to cope with the increase in hormonal needs, the depletion of the iodine load. But imbalances are possible, which is not without consequence on the maternal and fetal situation. All the interest of the preconception and prenatal consultation and its role in detecting pathologies early and treating them in time and by the optimal means.