Impacto del hipotiroidismo clínico y subclínico sobre la resultante materna y fetal Hospital Gineco-Obstétrico Enrique C. Sotomayor
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El hipotiroidismo se define como un trastorno caracterizado por una disminución de la producción de hormona tiroidea, que se traduce en una afectación del metabolismo sistémico. En general, es una causa poco frecuente de infertilidad pero cuando las pacientes logran embarazarse, ha sido asociado con complicaciones maternas y fetales como hipertensión, preeclampsia, diabetes gestacional, partos pretérmino, bajo peso al nacer, desprendimiento placentario y muerte fetal. Se realizó un estudio de tipo descriptivo, y de diseño no experimental, transversal y retrospectivo. Se incluyó a todas las pacientes del Hospital Enrique C. Sotomayor que acudieron al Servicio de Endocrinología de la consulta externa en el período de marzo del 2015 hasta febrero del 2016, con valores alterados de hormonas tiroideas durante la gestación actual sin diagnóstico previo y aquellas con patología tiroidea diagnosticada previamente a su embarazo. Además, se buscó evaluar el impacto del hipotiroidismo clínico y subclínico sobre la resultante materna y fetal en dicha población. Se pudo determinar que el mayor porcentaje correspondiente al 80.6% de pacientes no desarrollaron otras patologías durante el embarazo debido al control prenatal recibido. Mientras que las patologías más frecuentemente asociadas al hipotiroidismo fueron diabetes gestacional en un 8.3% y preeclampsia en un 7.4%. Los neonatos tuvieron una edad gestacional a término en un 93.5% y un peso normal en un 78.7%. También se logró determinar que el 3.7% de los recién nacidos presentó valores de TSH altos a través de la prueba de tamizaje neonatal. Por tal razón se concluyó que el impacto de esta patología endócrina fue bajo en relación a la resultante materna y fetal debido al adecuado control prenatal recibido por estas gestantes.
Hypothyroidism is definedas a condition in which exists a decrease of the production of thyroid hormone that affects the systemic metabolism. In general, hypothyroidismis an uncommon cause of infertility, but when patients can get pregnant, it’s been associated with maternal and fetal complications such as hypertension, preeclampsia, gestational diabetes, preterm deliveries, low-weight newborns, abruption placentae and intrauterine death. This projectwas descriptive, and with no experimental, transversal and retrospective design. It included all the patients treated in the Endocrinology Service of “Hospital Enrique C. Sotomayor” during March 2015 and February 2016, with abnormal thyroid hormones during the present pregnancy with no previous diagnosis and those who had a previous diagnosis of hypothyroidism.The objective was to assess the impact of this disorder in pregnant women and newborns. It was possible to determine that 80.6% of patients didn’t develop any disease during pregnancy due to the received prenatal control. The most common disorders were gestational diabetes in 8.3% and preeclampsia in 7.4%. The newborns had the normal gestational age in 93.5% of cases and an adequate weight in 78.7%. It was also possible to determine that 3.7% of newborns had high TSH according to neonatal screening. The conclusion was that this endocrine disorder had a low impact in pregnant women and newborns,due to the adequate prenatal control.
Hypothyroidism is definedas a condition in which exists a decrease of the production of thyroid hormone that affects the systemic metabolism. In general, hypothyroidismis an uncommon cause of infertility, but when patients can get pregnant, it’s been associated with maternal and fetal complications such as hypertension, preeclampsia, gestational diabetes, preterm deliveries, low-weight newborns, abruption placentae and intrauterine death. This projectwas descriptive, and with no experimental, transversal and retrospective design. It included all the patients treated in the Endocrinology Service of “Hospital Enrique C. Sotomayor” during March 2015 and February 2016, with abnormal thyroid hormones during the present pregnancy with no previous diagnosis and those who had a previous diagnosis of hypothyroidism.The objective was to assess the impact of this disorder in pregnant women and newborns. It was possible to determine that 80.6% of patients didn’t develop any disease during pregnancy due to the received prenatal control. The most common disorders were gestational diabetes in 8.3% and preeclampsia in 7.4%. The newborns had the normal gestational age in 93.5% of cases and an adequate weight in 78.7%. It was also possible to determine that 3.7% of newborns had high TSH according to neonatal screening. The conclusion was that this endocrine disorder had a low impact in pregnant women and newborns,due to the adequate prenatal control.
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Embarazo, Hipotiroidismo, Resultante materno, Resultante neonatal, Epidemiología descriptiva, Estudios retrospectivos, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador