The Condition of Thyroid and Fetoplacental Systems in Pregnant Women with Clinically Euthyroid Goiter

Abstract

The aim is to study a condition of thyroid and fetoplacental systems at pregnant women with clinically euthyroid goiter. Materials and methods: 116 pregnant women have been included in the basic group with clinically euthyroid goiter. The control group was made by 60 pregnant women with physiologically proceeding pregnancy, not having anamnestic and the clinical data on diseases of the thyroid. Inspection included: definition of concentration thyroid-stimulating hormone (TSH) and free thyroxine (fT4) by a radio-immunologic method, sets “RIA-gnost” (France) and the maintenance of antibodies to thyroid peroxydase (anti-TPO) by a method hard phase immune-enzyme analysis; ultrasonic assessment of a thyroid with the help of device SONOACE 8800 “GAIA MT”; ultrasonic fetometry, placentography, measurement of amniotic fluid volume, doppler ultrasound examination of the blood flow, an estimation of a functional condition of a fetus on parameters of its biophysical profile (BP) and cardiotocography (CTG), carried out on device “Oxford Sonicaid Team S8000”. Results: At studying hormonal function thyroid systems at 25 pregnant (21.6%) with euthyroid goiter in the third trimester of pregnancy a level fT4 norms were lower and had values from 4.5 up to 6.9 ng/ml, therefore an average level fT4 at pregnant women of the basic group was authentically lower, than in control (8.26 ± 0.30 and 10.71 ± 0.52 ng/ml, accordingly). At the retrospective analysis it is established, that only at 5 of 116 (4.3%) pregnant women with a goiter were not complications pregnancy, at the others — 111 (95.7%) took place a combination various obstetric complications: an anemia — at 72 (62.0%), threat noncarrying of pregnancy — at 75 (64.6 %), an early toxicosis — at 45 (38.6%), a gestosis — at 47 (40.5%) which frequency authentically is higher, than in control group: 20.0%, 25.0%, 16.6%. 20.0%, accordingly, р < 0.05. Average Estimation CTG at patients of the basic group is authentically lower, than in control (7.2 ± 0.1; 7.9 ± 0.07 points accordingly, р < 0.05). The expressed infringement of biophysical activity of a fetus in the basic group proved to be true lower average estimation BP (8.3 ± 0.12 a point), than in control group (9.8 ± 0.13 a point). With a goiter the arrest of development of an intra-uterine fetus is diagnosed for pregnant women — at 19 (16.4%), infringement placentation — at 14 (12.1%), hypamnions - at 27 (23.3%), that is authentically more often, than in control group (9.5%; 3.3%; 3.3%, accordingly, р < 0.05). Conclusion: Thus, at pregnant women with euthyroid goiter decrease in thyroid function in second half of the pregnancy, resulting to development of hypothyroxinemia in 21,6 % of supervision is marked. Pregnancy at patients with euthyroid goiter frequently has the complicated character. At women with euthyroid goiter of change in fetoplacental system meet more often and in a significant greater measure that demands their duly revealing and correction.