Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol
American Journal of Internal Medicine
Volume 8, Issue 1, January 2020, Pages: 19-23
Received: Dec. 27, 2019;
Accepted: Jan. 6, 2020;
Published: Jan. 13, 2020
Views 239 Downloads 66
Díaz Arizmendi Diana Elizabeth, Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Mexico
Mendieta Zerón Hugo, Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Mexico;Research Department, “Mónica Pretelini Sáenz” Maternal-Perinatal Hospital (HMPMPS) and Ciprés Grupo Médico (CGM), Toluca, Mexico
Hyperthyroidism is one of the main endocrinopathies during pregnancy. The aim of this project was to identify the degree of control of hyperthyroid pregnant women based on the recommendations of the American Thyroid Association (ATA) in a real situation without the availability of propylthiouracil. This was a descriptive, retrospective and longitudinal study, including medical files of pregnant women with hyperthyroidism between 18 and 35 years. They were classified as having "Adequate" control if their thyroid profiles were within the recommendations of the ATA and had no adrenergic symptoms; and were categorized as having "Inadequate" control if they were not stabilized with monotherapy, or if they required high doses of antithyroid drugs or beta-blockers or showed serious complications including the need of an Intensive Care Unit (ICU) for mothers or neonates. The Chi square test was performed between treatment groups during the third trimester and the complications of pregnant women or neonates. A total of 173 hyperthyroid pregnant women were studied with an average age of 21 ± 4.7 years. Of the 33 patients with hyperthyroidism who received monotherapy with methimazole until the end of pregnancy, 23 (69.69%) were classified as having "Adequate" control. In a real life situation there is delay in the diagnosis of hyperthyroidism during pregnancy but even without propylthiuracil, an “Adequate” control can be reached in up to 20.53% of cases based on a methimazole monotherapy.
Díaz Arizmendi Diana Elizabeth,
Mendieta Zerón Hugo,
Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol, American Journal of Internal Medicine. Special Issue: Thyroid in Systemic Diseases.
Vol. 8, No. 1,
2020, pp. 19-23.
Ahmad S, Geraci SA, Koch CA. Thyroid disease in pregnancy: (Women’s Health Series). South Med J 2013; 106: 532–8.
Bucci I, Giuliani C, Napolitano G. Thyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance. Front Endocrinol 2017; 8: 137.
King JR, Lachica R, Lee RH, et al. Diagnosis and Management of Hyperthyroidism in Pregnancy: A Review. Obstet Gynecol Surv 2016; 71: 675-85.
May L. Cardiac Physiology of Pregnancy. Compr Physiol 2015; 5: 1325–44.
Cooper DS, Laurberg P. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol 2013; 1: 238–49.
Mallela MK, Strobl M, Poulsen RR, et al. Evaluation of developmental toxicity of propylthiouracil and methimazole. Birth Defects Res B Dev Reprod Toxicol 2014; 101: 300–7.
Khan I, Okosieme O, Lazarus J. Antithyroid drug therapy in pregnancy: a review of guideline recommendations. Expert Rev Endocrinol Metab 2017; 12: 269–78.
Andersen SL, Laurberg P. Managing hyperthyroidism in pregnancy: current perspectives. Int J Womens Health 2016; 8: 497-504.
Fumarola A, Di Fiore A, Dainelli M, et al. Therapy of hyperthyroidism in pregnancy and breastfeeding. Obstet Gynecol Surv 2011; 66: 378-685.
Yakoob MY, Bateman BT, Ho E, et al. The risk of congenital malformations associated with exposure to β-blockers early in pregnancy: a meta-analysis. Hypertension 2013; 62: 375-81.
Bergman JEH, Lutke LR, Gans ROB, et al. Beta-Blocker Use in Pregnancy and Risk of Specific Congenital Anomalies: A European Case-Malformed Control Study. Drug Saf 2018; 41: 415-27.
Villalobos-Hernández A, Campero L, Suárez-López L, et al. [Teen pregnancy and educational gaps: Analysis of a national survey in Mexico]. Salud Publica Mex 2015; 57: 135–43.
OCDE. Overweight & Obesity [Internet]. Disponible en: https://www.oecd.org/centrodemexico/estadisticas/.
Marchi J, Berg M, Dencker A, et al. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 2015; 16: 621-38.
Iwen KA, Lehnert H. [Thyroid and pregnancy]. Internist 2018; 59: 654–60.
Abalovich MS. Fisiología tiroidea y embarazo. Aspectos maternos, placentarios y fetales. Rev Argent Endocrinol Metab 2003; 40: 23–31.
Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid 2017; 27: 315–89.
Santiago P, Berrio M, Olmedo P, et al. Valores de referencia de hormonas tiroideas en la población de mujeres gestantes de Jaén. Endocrinol Nutr 2011; 58: 62–7.
Wei Q, Zhang L, Liu XX, et al. [Clinical analysis of the specific reference intervals of thyroid index for normal pregnant women]. Zhonghua Fu Chan Ke Za Zhi 2018; 53: 299-303.
Rivera ZR, Aguilera TJ, Larraín HA. Epidemiología del virus papiloma humano (HPV). Rev Chil Obstet Ginecol 2002; 67: 501-6.
Poppe K, Hubalewska-Dydejczyk A, Laurberg P, et al. Management of Hyperthyroidism in Pregnancy: Results of a Survey among Members of the European Thyroid Association. Eur Thyroid J 2012; 1: 34–40.
Clementi M, Di Gianantonio E, Cassina M, et al; SAFE-Med Study Group. Treatment of hyperthyroidism in pregnancy and birth defects. J Clin Endocrinol Metab 2010; 95: E337-E341.
Andersen SL, Olsen J, Wu CS, et al. Birth defects after early pregnancy use of antithyroid drugs: a Danish nationwide study. J Clin Endocrinol Metab 2013; 98: 4373-81.
Mendieta-Alcántara GG, Santiago-Alcántara E, Mendieta-Zerón H, et al. [Incidence of congenital heart disease and factors associated with mortality in children born in two Hospitals in the State of Mexico]. Gac Med Mex 2013; 149: 617-23.
Teng W, Shan Z, Patil-Sisodia K, et al. Hypothyroidism in pregnancy. Lancet Diabetes Endocrinol 2013; 1: 228-37.