Hashimoto’s thyroiditis and obstetric complications: report of a complex clinical case
Keywords:
TIROIDITIS DE HASHIMOTO; HIPOTIROIDISMO; PREECLAMPSIA; PARTO PRETÉRMINO; RESTRICCIÓN DE CRECIMIENTO INTRAUTERINO.; HASHIMOTO’S THYROIDITIS; HYPOTHYROIDISM; PREECLAMPSIA; PRETERM DELIVERY; INTRAUTERINE GROWTH RESTRICTION.; TIREOIDITE DE HASHIMOTO; HIPOTIREOIDISMO; PRÉ-ECLÂMPSIA; PARTO PREMATURO; RESTRIÇÃO DO CRESCIMENTO INTRAUTERINO.Abstract
Introduction: hashimoto’s hypothyroidism is an autoimmune disease that represents the most common cause of hypothyroidism in regions with sufficient iodine, and its prevalence is significant among women of reproductive age.
Objective: to describe the therapeutic management of a patient with Hashimoto’s thyroiditis during pregnancy.
Case Report: a 36-year-old woman, with a clinical history of Hashimoto’s hypothyroidism under regular treatment, presented with elevated antibody titers at 14 weeks of gestation and sought medical consultation due to decompensation. A difficult-to-control hypothyroidism was identified, secondary to active Hashimoto’s thyroiditis and insufficient therapeutic adherence during the preconception stage. This combination favored an unfavorable endocrine and immunological environment, resulting in hypertensive disorders of pregnancy, as well as preterm delivery and intrauterine growth restriction.
Conclusions: hashimoto’s thyroiditis is a common cause of hypothyroidism during pregnancy, and its proper management is crucial to avoid both maternal and fetal complications. Monitoring thyroid function and antibody levels is essential to adjust treatment and prevent adverse outcomes. Unfortunately, this did not occur in our case, optimal TSH levels were never achieved, and adverse results were experienced.
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