Gestational thyrotoxicosis associated with emesis in early pregnancy

Citation:
J.R. N, A. A, Z.P. Q, C.S. K. "Gestational thyrotoxicosis associated with emesis in early pregnancy." East Afr Med J. 2009;86(2):55-8.

Abstract:

OBJECTIVES:
To determine the thyroid profile and the prevalence of gestational thyrotoxicosis among women with emesis during early pregnancy.

DESIGN:
A descriptive cross-sectional study.

SETTING:
Kenyatta National Hospital acute gynaecology ward and the ante-natal clinic.

SUBJECTS:
Seventy two women presenting with emesis up to 16 weeks gestation.

MAIN OUTCOME MEASURES:
The levels of FT3, FT4, TSH and beta-hCG during the first 16 weeks of gestation. Correlation between the thyroid hormones and beta-hCG as well as the severity of vomiting was also done.

RESULTS:
The point prevalence of gestational thyrotoxicosis was 8.3%. There was a significant positive correlation between beta-hCG levels and FT3 and FT4 (P-values < 0.05), and a significant negative correlation between beta-hCG and TSH (P < 0.05). Correlation between the severity of vomiting and the thyroid hormones as well as beta-hCG was not statistically significant. Patients' age ranged from 14-38 years (median 26). Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients (84.7%) had one to five episodes of vomiting per day. Peak beta-hCG was at 12-15 weeks gestation.

CONCLUSIONS:
Thyrotoxicosis does occur among women with emesis in pregnancy in this set-up. Screening for it may be beneficial to such women and also those with high serum beta-hCG levels above the median for the gestational age.

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