Diffuse non-toxic goiter and pregnancy

Abstract

The aim of this study was to investigate of effect of pregnancy on the thyroid sizes and function at the patients with diffuse non-toxic goiter in a region of marginal iodine deficiency. Materials and methods: 132 pregnant women in the age of 18-39 years, including 110 with diffuse non- toxic goiter and 22 pregnant women with a normal thyroid gland, were examined. 30 patients with diffuse non-toxic goiter of the first degree received 200 мкг per day of KI (iodid- 200), 40 patients with diffuse non-toxic goiter of the second degree received a 25-75 micrograms/day thyroxine (euthyrox). 25 patients with diffuse non-toxic goiter had not received regular therapy. The autoimmune thyroiditis is revealed for 15 women with diffuse non-toxic goiter. They received a 75-100 micrograms/day euthyrox. We estimated volume of the thyroid gland by ultrasound, serum TSH and serum thyroid hormone in each trimester of pregnancy. Results: At the healthy women during pregnancy the percentage increase of volume of a thyroid gland has constituted 24,3±0,2%. At the patients with diffuse non-toxic goiter, not receiving therapy, the thyroid gland was authentically increased at 37,1±1,1%. At the pregnant women receiving iodidum the percentage increase of volume of a thyroid gland has constituted 12,3±0,7%. After of a euthyrox therapy there was a relative decrease of the thyroid volume by 13,7±0,5%. In the group of healthy women a TSH level has increased inconsiderable from l,3±0,6mU/l to l,6±0,2mU/l to the end of pregnancy. During pregnancy in the group of women with diffuse non-toxic goiter without treatment rising the TSH values in a blood from l,4±0,3mU/I to 2,3±0,2 mU/l was revealed. The mean TSH levels of the goitrous pregnant group, receiving iodidum, essentially did not vary during pregnancy. In the goitrous pregnant group, receiving euthyrox, a TSH level has decreased considerably from l,8±0,5mU/l to 0,6±0,2 mU/l to the end of pregnancy. TSH values and free T4 in all the pregnant women were within the reference range in a blood of the healthy nonpregnant women. Was not observed of differences of pregnancy course and term delivery in compared groups. The high frequency of complications of pregnancy is connected to availability of the not diagnosed autoimmune thyroiditis. Conclusion: These results recommend to usage of iodine at the women with a not enlarged thyroid gland and with diffuse non-toxic goiter of the first degree and nonsupressic doses of thyroxine at the women with diffuse non-toxic goiter of the second degree during pregnancy.

Keywords

non-toxic goiter / pregnancy

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