Optimal treatment of hypothyroidism associated with live birth in cases of previous recurrent placental abruption and stillbirth

Neil K Vanes; Dorreh Charlesworth; Rabia Imtiaz; Philip Cox; Mark D Kilby; Shiao Y Chan

doi:10.1016/j.ijgo.2013.05.025

Optimal treatment of hypothyroidism associated with live birth in cases of previous recurrent placental abruption and stillbirth

Neil K Vanes, Dorreh Charlesworth, Rabia Imtiaz, Philip Cox, Mark D Kilby, Shiao Y Chan

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

OBJECTIVE: To examine the clinical management of and placentas from pregnant women with hypothyroidism and obstetric history of recurrent stillbirth in order to identify possible etiologic mechanisms.

METHODS: Two cases involving 26-year-old women with hypothyroidism and history of recurrent stillbirth are reported. Placentas from all of the women's pregnancies were compared in order to identify histologic similarities.

RESULTS: In both cases, multifocal hemorrhagic infarctions and abruptions were seen, indicating progressive uteroplacental ischemic damage leading to stillbirth. Thrombophilia, infection, and diabetes tests were all negative. With meticulous monitoring and normalization of thyroid function by end of first/early second trimester in subsequent pregnancies, there were live births and no evidence of infarction on placental histology.

CONCLUSION: The 2 reported cases raise the possibility of uteroplacental ischemia and placental abruption being mechanisms by which hypothyroidism can lead to stillbirth; they also highlight the potential of minimizing this risk via adequate levothyroxine treatment from early pregnancy.

Original language	English
Pages (from-to)	196-9
Number of pages	4
Journal	International Journal of Gynecology & Obstetrics
Volume	123
Issue number	3
DOIs	https://doi.org/10.1016/j.ijgo.2013.05.025
Publication status	Published - Dec 2013

Keywords

Abruptio Placentae
Adult
Female
Humans
Hypothyroidism
Ischemia
Live Birth
Placenta
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Recurrence
Stillbirth
Thyroxine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijgo.2013.05.025

Cite this

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title = "Optimal treatment of hypothyroidism associated with live birth in cases of previous recurrent placental abruption and stillbirth",

abstract = "OBJECTIVE: To examine the clinical management of and placentas from pregnant women with hypothyroidism and obstetric history of recurrent stillbirth in order to identify possible etiologic mechanisms.METHODS: Two cases involving 26-year-old women with hypothyroidism and history of recurrent stillbirth are reported. Placentas from all of the women's pregnancies were compared in order to identify histologic similarities.RESULTS: In both cases, multifocal hemorrhagic infarctions and abruptions were seen, indicating progressive uteroplacental ischemic damage leading to stillbirth. Thrombophilia, infection, and diabetes tests were all negative. With meticulous monitoring and normalization of thyroid function by end of first/early second trimester in subsequent pregnancies, there were live births and no evidence of infarction on placental histology.CONCLUSION: The 2 reported cases raise the possibility of uteroplacental ischemia and placental abruption being mechanisms by which hypothyroidism can lead to stillbirth; they also highlight the potential of minimizing this risk via adequate levothyroxine treatment from early pregnancy.",

keywords = "Abruptio Placentae, Adult, Female, Humans, Hypothyroidism, Ischemia, Live Birth, Placenta, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Recurrence, Stillbirth, Thyroxine",

author = "Vanes, {Neil K} and Dorreh Charlesworth and Rabia Imtiaz and Philip Cox and Kilby, {Mark D} and Chan, {Shiao Y}",

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doi = "10.1016/j.ijgo.2013.05.025",

language = "English",

volume = "123",

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TY - JOUR

T1 - Optimal treatment of hypothyroidism associated with live birth in cases of previous recurrent placental abruption and stillbirth

AU - Vanes, Neil K

AU - Charlesworth, Dorreh

AU - Imtiaz, Rabia

AU - Cox, Philip

AU - Kilby, Mark D

AU - Chan, Shiao Y

PY - 2013/12

Y1 - 2013/12

N2 - OBJECTIVE: To examine the clinical management of and placentas from pregnant women with hypothyroidism and obstetric history of recurrent stillbirth in order to identify possible etiologic mechanisms.METHODS: Two cases involving 26-year-old women with hypothyroidism and history of recurrent stillbirth are reported. Placentas from all of the women's pregnancies were compared in order to identify histologic similarities.RESULTS: In both cases, multifocal hemorrhagic infarctions and abruptions were seen, indicating progressive uteroplacental ischemic damage leading to stillbirth. Thrombophilia, infection, and diabetes tests were all negative. With meticulous monitoring and normalization of thyroid function by end of first/early second trimester in subsequent pregnancies, there were live births and no evidence of infarction on placental histology.CONCLUSION: The 2 reported cases raise the possibility of uteroplacental ischemia and placental abruption being mechanisms by which hypothyroidism can lead to stillbirth; they also highlight the potential of minimizing this risk via adequate levothyroxine treatment from early pregnancy.

AB - OBJECTIVE: To examine the clinical management of and placentas from pregnant women with hypothyroidism and obstetric history of recurrent stillbirth in order to identify possible etiologic mechanisms.METHODS: Two cases involving 26-year-old women with hypothyroidism and history of recurrent stillbirth are reported. Placentas from all of the women's pregnancies were compared in order to identify histologic similarities.RESULTS: In both cases, multifocal hemorrhagic infarctions and abruptions were seen, indicating progressive uteroplacental ischemic damage leading to stillbirth. Thrombophilia, infection, and diabetes tests were all negative. With meticulous monitoring and normalization of thyroid function by end of first/early second trimester in subsequent pregnancies, there were live births and no evidence of infarction on placental histology.CONCLUSION: The 2 reported cases raise the possibility of uteroplacental ischemia and placental abruption being mechanisms by which hypothyroidism can lead to stillbirth; they also highlight the potential of minimizing this risk via adequate levothyroxine treatment from early pregnancy.

KW - Abruptio Placentae

KW - Adult

KW - Female

KW - Humans

KW - Hypothyroidism

KW - Ischemia

KW - Live Birth

KW - Placenta

KW - Pregnancy

KW - Pregnancy Complications

KW - Pregnancy Outcome

KW - Recurrence

KW - Stillbirth

KW - Thyroxine

U2 - 10.1016/j.ijgo.2013.05.025

DO - 10.1016/j.ijgo.2013.05.025

M3 - Article

C2 - 24055168

SN - 0020-7292

VL - 123

SP - 196

EP - 199

JO - International Journal of Gynecology & Obstetrics

JF - International Journal of Gynecology & Obstetrics

IS - 3

ER -

Optimal treatment of hypothyroidism associated with live birth in cases of previous recurrent placental abruption and stillbirth

Abstract

Keywords

UN SDGs

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