The course of pregnancy and its result in women who have diffuse non-toxic goiter

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.

 

References

  1. Savel'eva, G. M., Sukhikh, G. T., Serov, V. N., & Radzinskij, V. E. (Eds.) (2015) Akusherstvo. Nacional'noe rukovodstvo [Obstetrics. National guidance]. Moscow: GEHOTAR-Media. [in Russian].
  2. Romanenko, T. G., Zhaloba, G. N. & Chajka, O. I. (2015) Sovremennyj vzglyad akushera-ginekologa na patologiyu shchitovidnoj zhelezy i eyo vliyanie na reproduktivnoe zdorov'e zhenshhiny (klinicheskaya lekciya) [The modern view of the obstetrician-gynecologist on the pathology of the thyroid gland and its effect on the reproductive health of women (clinical lecture)]. Zdorov'e zhenshhiny, 2, 8 13. [in Russian].
  3. Shi, X., Han, C., Li, C., Mao, J., Wang, W., Xie, X., et al. (2015) Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China. J Clin Endocrinol Metab., 100(4), 1630 8. doi: 10.1210/jc.2014-3704.
  4. Mao, G., Ding, G., Lou, X., Zhang, R., Zheng, P., Mo, Z., et al. (2015) Survey of iodine nutritional status in 2011, Zhejiang, China. Asia Pac J Clin Nutr., 24(2), 234 44. doi: 10.6133/apjcn.2015.24.2.08.
  5. Wang, K., Zhang, J., Li, F., Zhang, W., Wang, H., Ding, L., et al. (2017) Urinary iodine in early pregnancy is associated with subclinical hypothyroidism in Tianjin, China: an observational study. BMC Endocr Disord., 17(1), 10. doi: 10.1186/s12902-017-0162-x.
  6. Brunn, J., Block, U., Ruf, G., Bos, I., Kunze, W. P. & Scriba, P. C. (1981) Volumetric analysis of thyroid lobes by real-time ultrasound (author's transl). Dtsch Med Wochenschr. 106(41), 1338 40. doi: 10.1055/s-2008-1070506.
  7. Nazarenko, G. I. & Kishkun, A. A. (2000) Klinicheskaya ocenka rezul'tatov laboratornykh dannykh [Clinical evaluation of laboratory data]. Moscow : Medicina. [in Russian].
  8. Kaminskyj, O. V. & Tatarchuk, T. F. (2017) Hipotyreoz i vahitnist: novi rekomendatsii shhodo osoblyvostei diahnostyky i taktyky likuvannia [Hypothyroidism and pregnancy: new recommendations on the features of the diagnosis and treatment modality]. Mizhnarodnyi endokrynolohichnyi zhurnal, 13(2), 152 157. doi: 10.22141/2224-0721.13.2.2017.100605 [in Ukrainian].
  9. Liu, H., Shan, Z., Li, C., Mao, J., Xie, X., Wang, W., et al. (2014) Maternal subclinical hypothyroidism, thyroid autoimmunity, and the risk of miscarriage: a prospective cohort study. Thyroid., 24(11), 1642–9. doi: 10.1089/thy.2014.0029.

Downloads

How to Cite

1.
Shelestovа LP, Radchenko NМ. The course of pregnancy and its result in women who have diffuse non-toxic goiter. Pathologia [Internet]. 2018May3 [cited 2026May23];15(1). Available from: https://pat.zsmu.edu.ua/article/view/129187

Issue

Vol. 15 No. 1 (2018)

Section

Original research

License

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Лицензия Creative Commons