Перебіг вагітності та її завершення в жінок із дифузним нетоксичним зобом

L. P. Shelestovа; N. М. Radchenko

doi:10.14739/2310-1237.2018.1.129187

Authors

L. P. Shelestovа Donetsk National Medical University, Lyman, Ukraine,
N. М. Radchenko Donetsk National Medical University, Lyman, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2018.1.129187

Keywords:

goiter, pregnancy, parturition, obstetric labor complications

Abstract

Aim – to study the peculiarities of the pregnancy course and its result with women who have diffuse non-toxic goiter.

Materials and methods. The course of pregnancy and its result in 75 women with diffuse non-toxic goiter and in 75 women without thyroid pathology has been studied. The amount of thyroid-stimulating hormone (TSH), free triiodothyronine (FT₃) and free thyroxin (FT₄) was defined in blood serum, the concentration of iodine – in urine.

Results. The pregnancy in women who have diffuse non-toxic goiter goes with mild iodine deficiency (median 66.0 μg/l), an increase in TSH, a decrease in thyroid hormones and an integral thyroid index, compared with pregnant women without pathology of the thyroid gland. In 78.7 % (95 % CI 68.1–86.4 %) of women with diffuse non-toxic goiter, the thyroid gland enlargement is first detected during pregnancy. In 32.0 % (95 % CI 22.5–43.2 %) of women with diffuse nontoxic goiter in the second half of pregnancy subclinical hypothyroidism is developed. The presence of diffuse non-toxic goiter in the pregnant in comparison with the women without thyroid pathology increases the possibility of spontaneous abortion (OR 4.2; 95 % CI 2.0–8.9), iron-deficiency anemia (OR 2.3; 95 % CI 1.1–4.8), preeclampsia (OR 2.7; 95 % CI 1.2–6.2), placental dysfunction (OR 6.3; 95 % CI 3.1–12.8), fetal growth retardation (OR 5.6; 95% CI 1.2–26.6), premature labor (OR 5.6; 95 % CI 1.2–26.6), untimely outpouring of amniotic fluid (OR 2.2; 95 % CI 1.1–4.4), labor abnormalities (OR 2.8; 95 % CI 1.2–7.0).

Conclusions. In women with diffuse non-toxic goiter the likelihood of complications increases during pregnancy and childbirth, which points to the need to develop therapeutic and preventive measures aimed at their reduction.

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