Thyroid storm in pregnancy: a review.

Area of Science:

• Endocrinology
• Maternal-Fetal Medicine
• Critical Care Medicine

Background:

• Thyroid storm is a life-threatening endocrine emergency characterized by excessive circulating thyroid hormones.
• It leads to multiorgan dysfunction and systemic decompensation, often triggered by underlying hyperthyroidism and an acute event.
• Managing thyroid storm during pregnancy presents distinct diagnostic and therapeutic complexities.

Purpose of the Study:

• To highlight the critical need for prompt recognition of thyroid storm in pregnant patients.
• To emphasize the unique challenges in diagnosing and treating thyroid storm during gestation.
• To underscore the importance of adapting management strategies for pregnant individuals.

Main Methods:

• Thyroid storm diagnosis is primarily clinical, indicated by hyperpyrexia, tachyarrhythmias, heart failure, and neurological symptoms.
• Existing diagnostic scoring systems for thyroid storm lack validation in pregnancy.
• Treatment involves multidisciplinary care, supportive measures, and specific medications like anti-thyroid drugs, beta-blockers, iodine, and glucocorticoids, all requiring careful modification for pregnancy.

Main Results:

• The clinical presentation of thyroid storm includes fever, rapid heart rate, heart failure, and altered mental status.
• Pregnancy necessitates modified treatment protocols to mitigate risks to both mother and fetus.
• Specialized management approaches are crucial for successful outcomes.

Conclusions:

• Early identification of thyroid storm in pregnancy is essential.
• Timely and appropriate medical interventions are critical for managing this condition in pregnant individuals.
• Adapting standard treatment protocols is paramount to ensure maternal and fetal safety.