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 nausea andvomiting and thyroid dysfunction after 18-20 weeks of pregnancy. the aim of the study was to determine the importance of routine assessmentof thyroid function in pregnant women with hyperemesis gravidarum, especially those with clinical features of hyperthyroidism.materials and methods: 135 patients with hyperemesis gravidarum admitted to an ob-gyn hospital were selected. after excluding criteria,103 patients underwent investigations includingthyroid function tests and p-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). beta-hcg in first group was 59406±14899miu/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 hyperthyroidism. thyroid function tests were donefor all of 35 patients after 4 weeks routine therapy for hyperemesis gravidarum. thyroid function tests normalized in 11 patients with hyperemesis graridarum but remained abnormal in22 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 durationand dose of therapy were 2.76 months and 60.63mg/d for anti-tpo negative and 5.33 monthsand 170 m&,d for anti-tpo positive patients respectively.conclusion: in our study, thyroid, dysfunctionin hyperemesis gravidarum was 35%, with 20%of the patients needing anti-thyroid therapy. afemale predominance among offspring of motherswith hyperemesis gravidarum was observed.routine assessment of thyroid function is necessaryfor women with hyperemesis gravidarumespecially in patients with clinical features ofhyperthyroidism. ptu needs to be considered inhyperemesis .gravidarum with severe weightloss, vomiting