Gestation thytoxicosis associated with emesis in early pregnancy

Abstract

Objectives: To determine the thyroid profile and the prevalence of gestational thyrotoxicosis among women with emesis during early pregnancy. Design: A descriptive cross - sectional study. Setting: Kenyatta National Hospital acute gynaecology ward and the ante-natal clinic. Subjects: Seventy two women presenting with emesis up to 16 weeks gestation. Main outcome measures: The levels of FT3, FT4, TSH and β-hCG during the first 16 weeks of gestation. Correlation between the thyroid hormones and β-hCG as well as the severity of vomiting was also done. Results: The point prevalence of gestational thyrotoxicosis was 8.3%. There was a significant positive correlation between β-hCG levels and FT3 and FT4 (P-values < 0.05), and a significant negative correlation between β-hCG and TSH (P < 0.05). Correlation between the severity of vomiting and the thyroid hormones as well as β-hCG was not statistically significant. Patients' age ranged from 14-38 years (median 26). Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients (84.7%) had one to five episodes of vomiting per day. Peak β-hCG was at 12 - 15 weeks gestation. Conclusions: Thyrotoxicosis does occur among women with emesis in pregnancy in this set-up. Screening for it may be beneficial to such women and also those with high serum β-hCG levels above the median for the gestational age