Mild thyroid abnormalities and recurrent spontaneous abortion: Diagnostic and therapeutical approach

PROBLEM. The aim of this study is to evaluate the role of mild thyroid abno rmalities in recurrent spontaneous abortion, and to assess the effects of t wo different therapeutical protocols. METHOD: A prospective study in the population of recurrent aborters with mi ld thyroid abnormalities, evaluating the obstetric outcome in 42 patients. Sixteen thyroid autoantibodies positive patients were treated with thyroid replacement therapy, while 11 patients received intravenous immunoglobulins (IVIG). Fifteen patients, characterized by negative antithyroid antibodies , and having underlying thyroid pathology. were treated with thyroid replac ement therapy. RESULTS: Among patients with thyroid antibodies, 6 out of the 11 pregnancie s (54.5%) treated with IVIG ended in live birth. In the thyroid supplementa tion group, 13 out of 16 pregnancies (81.2%) ended in live birth. Only one pregnancy loss occurred among patients with a mild underlying thyroid patho logy treated with thyroid replacement therapy. CONCLUSIONS: Mild thyroid abnormalities are associated with an increased ra te of miscarriage. This poor obstetrical prognosis seems to be related to a n impaired thyroid adaptation to pregnancy. Thyroid replacement therapy app ears to be more effective than IVIG in preventing a new miscarriage.