Experience in organizing screening of thyroid pathology during pregnancy in the region of iodine deficiency

Introduction. Thyroid gland dysfunction has significant effects on the course of pregnancy and unborn child’s health. But at the same time, pregnancy itself affects the production of thyroid hormones, especially on the top of already administered thyropathy, as well as against the background of iodine deficiency in the region.

Objective of the study. Assess the thyroid pathology profile and methodological approaches to optimization of care for pregnant women for timely prevention and early detection of thyroid gland dysfunction through the example of the operation of Woman’s Health Clinic in the iodine-deficient region (Republic of Bashkortostan).

Materials and methods. The analysis of thyroid function was carried out in 450 pregnant women, who were registered with the clinic in 2019. Both subclinical and manifest hypothyroidism was detected in 18.6 and 8.7% of pregnant women, respectively. Results of the study. The observation was carried out jointly by an obstetrician-gynecologist and an endocrinologist (along with the implementation of a set of studies regulated by the recommendations of the Ministry of Health of the Russian Federation). Of the total number of the observed patients, 438 pregnant women were living in the region with insufficient iodine intake (Republic of Bashkortostan). The results obtained significantly exceed the literature data, which necessitates the development and implementation of regional programs for early diagnosis of thyroid dysfunction and its timely management in pregnant women under conditions of iodine deficiency.

Mandatory examination of thyroid function in all women in the early stages of pregnancy has been introduced.

Conclusion. Taking into account the effect of ethnicity on TSH and the iodine status in the region of residence, it can be assumed that the reference TSH values during pregnancy may be different in different regions and in different categories of women. Diagnostic criteria and indications for prescribing replacement therapy using levothyroxine sodium to treat hypothyroidism in pregnant women remain open for discussion.

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