MATERNAL AND PERINATAL OUTCOME IN THYROTOXICOSIS COMPLICATING PREGNANCY

In this report we describe 32 pregnancies complicated by hyperthyroidi sm cared for over a 7-year period at AIIMS, New Delhi. In 6 cases hype rthyroidism was diagnosed during pregnancy; others were diagnosed befo re conception and were on antithyroid therapy during pregnancy. For co ntrol of thyrotoxicosis thiourea derivatives, carbimazole (CMZ) and pr opylthiouracil (PTU), were both used. The dosage of antithyroid drugs could be decreased or stopped in the third trimester in only 28% cases , while 50% cases did not require any change in the dosage during gest ation and 21% required an increase in dosage with advancing gestation to control thyrotoxicosis. Maternal and fetal complications included p reterm labour (25%), PIH (22%), thyroid crisis (9%) and intrauterine g rowth retardation (13%). Thyroid status of neonates was found abnormal in 9% cases, including 1 case (3%) of neonatal thyrotoxicosis with go itre and 2 (6%) cases of neonatal hypothyroidism. One maternal death o ccurred due to thyroid storm. No case of stillbirth or perinatal death occurred in the present study. In our experience of 32 cases maternal and fetal complications are reported with increased frequency, requir ing close surveillance of thyroid status to maintain euthyroidism and intensive fetal monitoring during pregnancy to achieve good maternal a nd perinatal outcome.