Course and outcome of pregnancy in patients with hypothyroidism

This report presents the prospective analysis of 56 pregnant women with hypothyroidism. Patients with hypothyroidism diagnosed prior to pregnancy (46) were treated before and in the course of pregnancy with substitutional therapy. Patients with hypothyroidism verified in subclinical form during pregnancy (10) were not treated. The analysis of the pregnancy course revealed a significantly higher incidence of gestational diabetes mellitus and pre-eclampsia (p < 0.001). It may be suggested that hypothyroidism is one of the risk factors for the development of gestational diabetes, and also one of the pre-existing factors for development of pre-eclampsia. Delivery resulted in 83.9% of patients; in 12.8% it was prior to the term while spontaneous abortion occurred in 16.1% (in one third in the first trimester). Similar results were observed in pregnant women with subclinical hypothyroidism. There were 4.2% of stillbirths which corresponds to the rate of perinatal mortality. One infant was born with hydrocephalus while the others were healthy. In the authors' opinion it is necessary to achieve normal metabolic status before pregnancy, which should then be maintained with sub-stitutional therapy throughout the pregnancy.