FEATURES OF MANAGEMENT OF PREGNANCY IN WOMEN WITH DIFFUSE TOXIC GOITER

Euthyroid status is a necessary optimal condition for a favorable outcome of pregnancy in women with diffuse toxic goiter (DTG), which is considered as the most common cause of thyrotoxicosis during this period, and has a negative effect on the course and outcome of pregnancy. Different opinions existing in the scientific literature about the tactics of pregnancy management in women with DTG determine the relevance of this topic. Methods. The results of a study on the use of thyreostatic therapy in 67 pregnant women with DTG are presented. The main methods of evaluation in the study included thyroid echography in women throughout pregnancy and in newborns on the 4th-7th day of life, as well as determination of the thyroid-stimulating hormone (TSH), free thyroxine (Free T4) and TSH receptor antibodies (anti-TSHR) levels in the blood of pregnant women and in umbilical cord blood. Results. The results indicate a higher incidence of complications of pregnancy (early toxicosis - 83%, threatening miscarriage - 94%, placental insufficiency - 55%, gestosis -100%, fetal hypotrophy - 88%) and childbirth (premature delivery - 33%, fetal hypoxia - 44%) in women with thyrotoxicosis. The high incidence of goiter in newborns (more than 83%) is associated with the negative effect of transplacental transfer of thyreostatic drugs and anti - TSHR on the volume and functional status of thyroid gland in newborns. An important factor determining the need to optimize the doses of thyreostatic drugs is the high risk of developing neonatal hypothyroidism (in 53% of newborns). Conclusion. The high incidence of subclinical hypothyroidism in newborns (53%) from mothers with DTG requires the optimization of thyroid doses prescribed for the treatment of DTG during pregnancy.

diffuse toxic goiter, thyreostatic therapy, imidazole, propylthiouracil, thyroid gland, thyrotoxicosis, hypothyroidism, thyroid-stimulating hormone receptor antibodies