WHEN ANTITHYROID DRUGS MUST BE STARTED IN PATIENTS WITH HYPEREMESIS GRAVIDARUM?

Abstract

Objective: To find out role of anti-thyroid drugs in patients with Hyperemesis gravidarum and thyroid dysfunction. Methodology: One hundred thirty five patients with hyperemesis gravidarum who were admitted to obstetric and gynecology hospital were enrolled in this study. Thirty two patients were excluded because of diabetes mellitus and thyroid diseases. Hence, one hundred three patients underwent investigations including thyroid function test and beta-hCG (Human chorionic gonadotropin). Results: Thirty five women were found with abnormal thyroid function test with FT 4 1 (Free Thyroxin Index) 4.74 +/- 0.54 and in another group (68 women) was 2.9 +/- 0.39 (P<0.0001). B-hCG in first group was 59406 +/- 14899 miu/mt and in second group was 6750 3476 miu/mL (P<0.0001). In five patients PTU (propylthiouracil) was started due to severe sign and symptoms of hyperthyroidism. Thyroid function test was rechecked for all of 35 patients after four weeks routine therapy for hyperemesis gravidarum. Thyroid function test was normalized in 11 patients with hyperemesis graridarum but remained abnormal in 22 patients. Conclusion: In our study thyroid dysfunction in hyperemesis gravidarum was 35% and, 20% of patients needed anti-thyroid therapy. Routine assessment of thyroid function is necessary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. We must consider PTU (propylthouracil) in hyperemesis gravidarum with severe weight toss, vomiting and biochemical hyperthyroidism.