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Thyroid function in patients with hyperemesis gravidarum

R Bouillon, M Naesens, F A Van Assche

    American Journal of Obstetrics and Gynecology
    |August 15, 1982
    PubMed
    Summary
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    Severe hyperemesis gravidarum often causes elevated free thyroxine (T4) levels during pregnancy. This thyroxinemia, while not affecting pregnancy outcomes, was linked to lower birth weight in offspring.

    Area of Science:

    • Endocrinology
    • Maternal-Fetal Medicine
    • Obstetrics

    Background:

    • Hyperemesis gravidarum is a severe pregnancy complication characterized by intense nausea and vomiting.
    • Thyroid function abnormalities can occur during pregnancy, necessitating careful differential diagnosis.

    Purpose of the Study:

    • To investigate thyroid function, specifically free thyroxine (T4) and free triiodothyronine (T3) indices, in pregnancies complicated by severe hyperemesis gravidarum.
    • To determine the relationship between thyroid function abnormalities and pregnancy outcomes, including abortion rates, pregnancy duration, and birth weight.

    Main Methods:

    • Studied 33 consecutive pregnancies with severe hyperemesis gravidarum.
    • Measured free thyroxine (T4) and free triiodothyronine (T3) indices.

    Related Experiment Videos

  • Assessed thyrotropin response to thyrotropin-releasing hormone (TRH) in a subset of patients.

    • Main Results:

    • Elevated free T4 index was observed in 73% of patients; elevated free T3 index was less common.
    • No significant thyrotropin response to TRH was noted in tested patients, and classic hyperthyroid signs were absent.
    • Thyroxinemia resolved spontaneously within weeks, irrespective of antithyroid drug treatment, and did not impact abortion rates or pregnancy duration, but was associated with lower birth weight.

    Conclusions:

    • Severe hyperemesis gravidarum is frequently associated with elevated free T4 index, mimicking hyperthyroidism.
    • This condition should be considered in the differential diagnosis of thyrotoxicosis during pregnancy.
    • While not directly impacting pregnancy loss or duration, maternal thyroxinemia may be linked to reduced fetal growth.