MULTIGRAVIDA WITH UNCONTROLLED HYPERTHYROID AND BILATERAL PLEURAL EFFUSION

Muhammad Al Farisi Sutrisno(1*), Herlambang Herlambang(2), Firmansyah Firmansyah(3)

(1) Resident of Obstetrics and Gynecology, Faculty of Medicine, Jambi University, Raden Mattaher Hospital Jambi
(2) Sub Division of Maternal Fetal Medicine, Obstetrics and Gynecology, Faculty of Medicine, Jambi University, Raden Mattaher Hospital Jambi
(3) Sub Division of Social Obstetrics and Gynecology, Obstetrics and Gynecology, Faculty of Medicine, Jambi University, Raden Mattaher Hospital Jambi
(*) Corresponding Author

DOI: https://doi.org/10.25077/aoj.4.2.167-172.2020

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


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