Pattern, Clinical Presentation and Pregnancy Outcome of Thyroid Diseases in Pregnant Women at National Endocrine Referral Clinic of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia from June 2010 to June 2015

Abstract

Background: The major disorders of thyroid gland are hypothyroidism and hyperthyroidism and thyroid disorders are predominantly of autoimmune etiology in pregnant women. To date there is no study done in Ethiopia to show pattern and pregnancy outcomes of pregnant women with thyroid disorders. Objectives: To assess pattern of thyroid diseases, thyroid function test profiles, clinical presentations and pregnancy outcomes in pregnant women at National Endocrine Referral Clinics of Tikur Anbessa Specialized Hospital. Methods: A retrospective study was conducted at National Referral Endocrine Clinics of TASH from June 2010 to June 2015. All pregnant women with thyroid disorders were included in the study and patients’ charts were retrieved from follow up clinics and hospital archive by two trained residents of Internal medicine using pre-structured data collection tools. Results: Among a total of 1124 patients with endocrine disorders, 670 (59.6%) were patients with thyroid disorders and 9.25% (62) were pregnant women. Among pregnant women with thyroid disorders, majority, 51 (82.2%) were pregnant women with hyperthyroidism with mean (SD) age of 30 ± (6.45) years. Majority of patients with hyperthyroidism, 43(84.3%) were diagnosed to have TMNG followed by Graves’ disease. Among pregnant women with hypothyroidism, six were cases of iodine deficiency. The commonly seen symptoms of hyperthyroidism were, anterior neck swelling (94.1%), palpitation (47.1%) and heat intolerance (31.4%). Patients with hypothyroidism, accounted for 17.74% of thyroid diseases in pregnancy and the common symptoms were fatigue and cold intolerance each accounting for 9 (81.8%) of the cases. Most of pregnant women with hyperthyroidism, 37 (72.5%) gave birth to an alive neonate, 11 (21.6%) had abortion and the remaining 3 (5.9%) had IUFD. Conclusion: From our study, most of pregnant women with thyroid disorders were patients with hyperthyroidism. The pregnancy outcome of these patients was generally good. Recommendation: We recommend proper documentation and electronic medical recording to be practiced in the hospital and to have pre-pregnancy counseling for all reproductive age women who have follow up at endocrine referral clinics. We also recommend doing more comprehensive research on pregnancy outcomes of pregnant women with thyroid disorders and neonatal screening for congenital hypothyroidism.