Features of the pregnancy course and state of the feto-placental complex in women with thyroid pathology

Abstract

Pregnancy with thyroid pathology is a special situation that needs to be solved jointly by the gynecologist and endocrinologist. Endocrine disorders are often combined with somatic pathologythat poses additional difficulties in the tactics of pregnancy monitoring and delivery. Changes in pregnant woman with thyroid pathology differ from changes in physiological pregnancy. Objective — to determine the peculiarities of feto-placental complex functioning in patients with thyroid pathology. Materials and methods. Under observation, there were 85 women in the period from 6 to 40 weeks of gestation. The first group included 23 patients with diffuse nontoxic goiter (DNG), the second — 20 pregnant women with Graves’ disease, the third group — with hypothyroidism (n = 22). The control group consisted of 20 pregnant women without any endocrine pathology. Results and discussion. In terms of thyroid hormo­nes in women with Graves’ disease, there was a decrease in TSH levels with a higher level of free thyroxin, but in the second and third trimester, these indices did not differ from the normal against the background of treatment. The inherent disorders of homeostasis in women with thyroid diseases, even under compensa­ted conditions, lead to the development of complicati­ons of pregnancy and child­birth, among which the most frequent is the threat of interruption (77.2 %) and gestosis (63.6 %). The most pronounced complications were observed in groups of women with hypothyroi­dism and Graves’ disease. Conclusions. Clinical and laboratory signs of feto­placental insufficiency were established in 86.4 % of pregnant women with hypothyroidismaccording to the criteria of modern ultrasound and functional methods, 55 % with Graves’ disease, and 39.1 % with DNG. De­­compensated form of placental insufficiency was found predominantly in women with hypothyroidism, and reached 31.8 % of cases.