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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 08

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Ginecol Obstet Mex 2019; 87 (08)

Thyroid storm in pregnancy: A case report

Novoa-Reyes RH, Llancari-Melendes PA, de la Peña-Meniz WJ, Díaz-Seminario AM, Castillo-Gozzer GA, Cano-Loayza JC, Aguilar-Carrión JN

Language: Spanish
References: 23
Page: 555-562
PDF size: 695.29 Kb.


ABSTRACT

Background: Thyroid storm is a rare complication of hyperthyroidism, with 10 times greater risk of developing during pregnancy. The term "storm" describes the intensity of the clinical manifestation and the significant concentration of thyroxine (T4) and tri-iodothyronine (T3).
Clinical case: Woman of 25 years with a gestational age of 29 weeks with poor prenatal control, referred to our institution due to fetal tachycardia. Clinically, he had a heart rate of up to 161 per minute, a fetal heart rate of 178, hot skin, bilateral exophthalmos, Plumer's nails, bilateral 3N diffuse goiter, bilateral jugular vein enlargement, bilateral lung crepitations with predominance of bases, lower limb edema. He presented a score of 60 on the Burch and Wartofsky criteria for thyroid storm. Antithyroid drugs, beta blockers and support measures were established. Patient developed a threat of preterm delivery and persistent fetal tachycardia, so an emergency caesarean section was indicated.
Conclusions: Screening for hyperthyroidism in pregnant women with a personal history and symptoms is the best measure of thyroid storm prevention. The suspicion of thyroid storm should be treated immediately by a multidisciplinary team. Fetal well-being should be evaluated continuously and determine the end of pregnancy if there are fetal indications or the mother does not respond to the treatment established.


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