SUBCLINICAL THYROID DYSFUNCTION AND AUTOIMMUNE THYROID GLAND DISEASES LEVOTHYROXINE SUPPLEMENTATION IN CORRELATION TO GESTATIONAL CLINICAL OUTCOMES
Rehab M. Abdelrahman , Ahmed R.M. Ramy
Department Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University Cairo, Egypt.
Background: Auto immune thyroid diseases is a challenging cases scenario during pregnancy as the pathophysiological issues of autoimmunity could affect other systems other than thyroid gland wich could lead to multisystem disease affecting the clinical gestational outcomes at maternal and fetal aspects throughout the three gestational trimesters. Levothyroxine as line of management in cases of subclinical hypothyroidism have been proposed by various researchers all over the globe however the correlation to gestational outcomes improvement have not been adequately investigated. Methodology: A prospective research study conducted on pregnant women from the first gestational trimester till time of delivery. The research study was conducted in Ain Shams university maternity hospital from Janauary 2016 till September 2016, on 200 research study subjects screened for thyroid dysfunction were randomized in to two equal numbered research groups the levothyroxine research group and the control research group. Results: Statistical significant difference existed as regards preterm delivery and gestational age at termination (p values = 0.02, <0.001, consecutively), however there was no statistical significant difference between both research groups as regards preterm albor, placental abruption, preeclampsia, fetal growth restriction, PPROMS, placenta Previa, still birth, NICU admission (p values = 0.67, 0.35, 0.09, 0.43, 0.35, 0.48, 0.48, 0.09, consecutively) Conclusions: levothyroxine replacement therapy in thyroid peroxidase positive pregnant females with normal free T4 enhances gestational clinical outcomes and is valuable in decreasing preterm delivery