Evaluation of Thyroid Funtion Tests in Patients with Hyperemesis Gravidarum

yperemesis 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 and vomiting and thyroid dysfunction after 18-20 weeks of pregnancy. The aim of the study was to determine the importance of routine assessment of 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 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 hyperthyroidism. Thyroid function tests were done for 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 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 respectively. 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 mothers with hyperemesis gravidarum was observed. Routine assessment of thyroid function is necessary 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 hyperthyroidism.