[Hyperthyroidism during pregnancy: maternal-fetal outcomes]

Abstract

Purpose: to evaluate the experience of Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista 'Júlio de Mesquita Filho', in the follow-up of pregnant women with hyperthyroidism.

Methods: Sixty patients, divided in groups with compensated hyperthyroidism (CHG=24) and with uncompensated hyperthyroidism (UHG=36) were retrospectively studied and compared concerning clinical-laboratorial characteristics and intercurrences. The t-Student test, contingency tables, multiple linear regression and multiple logistic regression with significance level at 5.0% were used.

Results: propylthiouracil (PTU) was used by 94.0% of UHG and by 42.0% of CHG (p<0.0001); maternal complications close to delivery have occurred in 20.6% of UHG and in 11.8% of CHG, and UHG presented three fetal deaths, influenced by the mother age, higher level of T4L (lT4L) and of PTU dose (PTUd) in the third trimester (p=0.007); restriction of intra-uterine growth, influenced by lT4L and PTUd in the third trimester has occurred in nine UHG and in three CHG cases, and oligoamnios has occurred in 12 patients (83.3% of UGH and 16.7% of CGH), influenced by age and lT4L in the third trimester (p=0.04); the gestational age at delivery was 34.4+/-4.6 weeks in UHG and 37.0+/-2.5 in CHG, influenced by the T4Ll in the third trimester (p<0.05).

Conclusions: the UHG has presented less satisfactory results than CHG, influenced by high lT4L and PTUd in the third trimester, and by more advanced age of some pregnant women.