Hipertireoidismo na gravidez: Repercussões materno-fetais

Abstract

PURPOSE: to evaluate the experience of Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filhó, in the follow-up of pregnant women with hyperthyroidism. METHODS: Sixty patients, divided in groups with compensated hyperthyroidism (CHG=24) and with uncompensated hyperthyroidism (UHG=36) were retrospectively studied and compared concerning clinical-laboratorial characteristics and intercurrences. The t-Student test, contingency tables, multiple linear regression and multiple logistic regression with significance level at 5.0% were used. RESULTS: propylthiouracil (PTU) was used by 94.0% of UHG and by 42.0% of CHG (p<0.0001); maternal complications dose to delivery have occurred in 20.6% of UHG and in 11.8% of CHG, and UHG presented three fetal deaths, influenced by the mother age, higher level of 141(1141) and of PTU dose (PTUd) in the third trimester (p-0.007); restriction of infra-uterine growth, influenced by IT41 and PTUd in the third trimester has occurred in nine UHG and in three CHG cases, and oligoamnios has occurred in 12 patients (83.3% of UGH and 16.7% of CGH), influenced by age and IT4L in the third trimester (p=0.04); the gestational age at delivery was 34.41±b4.6 weeks in UHG and 37.01-2.5 in CHG, influenced by the T4LI in the third trimester (p<0.05). CONCLUSIONS: the UHG has presented less satisfactory results than CHG, influenced by high IT4L and PTUd in the third trimester, and by more advanced age of some pregnant women.