Multigravida With Uncontrolled Hyperthyroid and Bilateral Pleural Effusion

Abstract

Background: Hyperthyroid is a hypermetabolic condition caused by abnormal thyroid gland function resulting in overproduction and overexpression of thyroid hormone. The prevalence of hyperthyroid during pregnancy is 0.1-0.4%, where 85% of case are presented as grave’s disease. Objective: To report the treatment of uncontrolled hyperthyroid during pregnancy.Method: Case Report Case: Ms. S, Female, 33 years old, presenting with brethlessness since 5 days before admission. Breathlessness persist and aggravated by lying down position. The patient has history of hyperthyroid since 1 years before admission. The blood pressure was 120/80 mmHg, respiration rate 28 times/min, and body temperature 36,7oC. Uterus fundal height 26 cm, cephalic presentation, fetal heart rate 130 times/min, single fetus intrauterine and alive. Laboratoric test for leukocyte: 21,300/ul, T4 level 22.8 mg/dl dan T3 level 2.9 mg/dl. The patient diagnosed with G3P2A0 31-week gestational age single alive fetus intrauterine with uncontrolled hyperthyroid and bilateral pleural effusion. Treatment consist of propylthiouracil as the drug of choice for anti-thyroidal drug, nifedipine for gestational hypertension and furosemide to treat the pleural effusion. Conclusion: History taking, physical examination, thyroid function test, and maintaining euthyroidism during pregnancy is a key to reduce the risk of maternal and fetal complication.Keywords: hyperthyroid, pregnancy , IUGR

Hyperthyroidisme pada Kehamilan

“…Hipertiroidisme dapat dibagi menjadi subtipe yang berbeda dari etiologi yang mendasarinya, dan tiga subtipe yang paling umum adalah penyakit Graves, gondok toksik multinodular, dan adenoma toksik soliter 12 muda, dan insiden subtipe ini stabil dengan bertambahnya usia. Penyakit Graves adalah jenis hipertiroidisme nyata yang dominan pada wanita usia reproduksi dan dengan demikian juga merupakan jenis utama hipertiroidisme nyata pada kehamilan 13 .…”