Evaluation of Thyroid Funtion Tests in Patients with Hyperemesis Gravidarum

Hyperemesis gravidarum occurs in about 1.5% of pregnancies and is more common in Asian than in white women. Many patients do not need anti thyroid drugs, except for those with severe nau-sea and vomiting and thyroid dysfunction after 18-20 weeks of pregnancy. The aim of the study was to determine the importance of routine as-sessment of thyroid function in pregnant women with hyperemesis gravidarum, especially those with clinical features of hyperthyroidism. Materials and Methods: 135 patients with hy-peremesis gravidarum admitted to an Ob-Gyn hospital were selected. After excluding criteria, 103 patients underwent investigations including thyroid function tests and β-hCG. Results: 35 women were found to have abnormal thyroid function tests with FT4I 4.74 ± 0.54 and in another group (68 women) this was 2.9±0.39 (P<0.0001). B-hCG in first group was 59406±14899 mIU/mL and in second group was 6750±3476 mIU/mL (P<0.0001). In 5 patients, PTU was started due to severe signs and symptoms of hy-perthyroidism. Thyroid function tests were done for all of 35 patients after 4 weeks routine ther-apy for hyperemesis gravidarum. Thyroid func-tion tests normalized in 11 patients with hy-peremesis graridarum but remained abnormal in 22 patients hence; PTU was started and anti-TPO anti-body was measured; thyroid function tests were repeated monthly for all of them and PTU were adjusted accordingly. Means for duration and dose of therapy were 2.76 months and 60.63 mg/d for Anti-TPO negative and 5.33 months and 170 mg/d for Anti–TPO positive patients re-spectively. Conclusion: In our study, thyroid, dysfunction in hyperemesis gravidarum was 35%, with 20% of the patients needing anti-thyroid therapy. A female predominance among offspring of moth-ers with hyperemesis gravidarum was observed. Routine assessment of thyroid function is neces-sary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. PTU needs to be considered in hyperemesis gravidarum with severe weight loss, vomiting and biochemical hyperthyroid-ism.