A Rare Case of Myxedema in Pregnancy

Abstract

The incidence of hypothyroidism in pregnancy is 2-3%, subclinical hypothyroidism is 2-2.5% and overt hypothyroidism is 0.3-0.5%. Hypothyroidism may cause abortion, placental abruptions, pre-eclampsia, intrauterine growth restriction (IUGR), preterm delivery and mental retardation of the baby .Treating clinical and subclinical hypothyroidism may reduce adverse obstetric outcomes. Universal screening is currently not recommended. Thyroid dysfunction and thyroid autoimmunity are prevalent among women of reproductive age. Preconception or early pregnancy screening for thyroid dysfunction has been proposed but is not widely accepted. A 21year old primi with nine months of amenorrhoea with oligohydramnios with hypothyroidism was referred from outside for safe confinement. She had hoarseness of voice, nonpitting edema, puffiness of face and had high blood pressure (preeclampsia). Cesarean section was done and an alive male 2 kg baby was delivered and had feature of IUGR. Patient had atonic postpartum haemorrhage (PPH). She was resuscitated with blood and prostodin. She was advised to continue thyroid drugs. Preconception or early pregnancy screening for thyroid dysfunction is essential just like diabetics screening hence there is a need for increased awareness. The early diagnosis and treatment will solve the problems of hypothyroidism in pregnancy.