Hyperthyroid in Pregnancy: A Case Report

Abstract

Rajuddin Rajuddin, Budiman, Shalahuddin, Donny A.Taufika

Hyperthyroidism in pregnancy is generally caused by Grave's disease which can cause thyroid crises, premature, abortion and fetal death. Graves disease often becomes more severe in the first trimester of pregnancy and will experience an exacerbation in the postpartum period. A 35-year-old woman with a third pregnancy 23-24 weeks with fetal death in the womb. The patient has been suffering from Grave's disease for 10 years but has not taken the drug for the past 1 year. No history of trauma and bleeding. FT4 levels 75.62 pmol / L and TSHs levels 0.005 µIU / mL. Wayne's index score is 23 and the Burch Wartofsky scale is 45 or impending thyroid storm. Management of hyperthyroidism is given before termination of pregnancy. Pulmonary breath shortness at two hours after delivery and given a diuretic and vasodilator. Supervision is carried out until the patient's condition improves. The function of the thyroid gland in pregnancy is increased which is influenced by increased levels of thyroxin binding globulin (TBG), thyroid-stimulating factors (TSF) from the placenta and decreased iodine supply in the thyroid gland. These complaints are more severe in the first trimester of pregnancy and will experience an exacerbation in the postpartum period. In inadequate treatment, hyperthyroidism complicated to maternal heart failure and fetal death. Hyperthyroidism can cause complications in the mother and fetus and increase morbidity and mortality. Proper initial treatment will improve outcomes.