Endocrine Abstracts

Introduction: The occurrence of pregnancy in patients with hypothyroidism is a common event. Thyroxine requirements increase in nearly 80% of pregnant women. Educating young patients with hypothyroidism about the adaptation of treatment and the need for close biological monitoring helps prevent complications of maternal hypothyroidism in the fetus.

Objective: The objective of our study was to assess the knowledge of patients about the management of levothyroxine during pregnancy and the need for TSH monitoring during pregnancy.

Patients and Methods: A descriptive study included 33 patients followed for hypothyroidism in the pregnancy consultation at the Endocrinology and Metabolic Disease Department at CHU Ibn Rochd. We developed a questionnaire of misconceptions reported by our pregnant women in our context. The analysis was performed using the SPSS software.

Results: The average age of our patients was 32 years (21-49). A low socioeconomic level was observed in 89% of patients. The referring physician was a gynecologist in 76% of cases, a general practitioner in 19% of cases, and an endocrinologist in 5% of cases. Pregnancy was not desired in 17% of cases, and 83.3% of patients had planned their pregnancy. The gestational age at the first consultation with us was on average 20 weeks. The average dose of levothyroxine before pregnancy was 100 µg/day. None of the patients had a pre-conception consultation for TSH measurement and adaptation of levothyroxine dose. None of the patients knew their TSH target. Discontinuation of levothyroxine upon pregnancy diagnosis was adopted by 46.1% of patients, and 53.9% of patients kept the same dose while waiting to see their doctor; however, none of the patients titrated the levothyroxine dose. Regarding complications of hypothyroidism on fetal development, 98.8% had no idea about these consequences. For breastfeeding, 74.3% of pregnant women thought that levothyroxine passes into breast milk but did not know if they should stop it.

Conclusion: Women with hypothyroidism of childbearing age should receive education on the vital necessity of substitute treatment and its adaptation before conception and during pregnancy, as well as the need for biological monitoring, to prevent the consequences of maternal hypothyroidism on fetal brain development.