Kehamilan Dengan Hipertiroid

Dr.dr. Mohd. Andalas, SpOG. FMAS*, Lutfi**, Indra**

*Departemen Obstetri & Ginekologi
**PPDS Obstetri & Ginekologi
***PPDS Obstetri & Ginekologi

Fakultasi Kedokteran UNSYIAH/ FKUI

RSUD Zainoel Abidin

Abstract
Introduction
Pregnancy with hyperthyroidism was expected 2:1000 of all pregnancies, if hyperthyroidsm
uncontrolled can cause thyroid crisis, preterm labor, abortion and fetal death.
Hyperthyroidism in pregnancy is difficult to diagnose because of the pregnancy itself causes
physiological changes that resemble the state of hyperthyroidism. However, early detection to
detect hyperthyroidism in pregnant women is very important, since pregnancy itself is a stress
for the mother, especially if accompanied by a state of hyperthyroidism.

Case
It has been reported of a woman aged 35 years with severe preeclampsia and
Hyperthyroidism G5P4A0 40-41 weeks gestational age, singleton live head presentation, not
in labor, unrippen cervix. Diagnosis of hyperthyroidism in pregnancy is based on anamnesis,
physical examination, laboratory. Found body weakness, heart palpitations, sweating, signs
of tachycardia and mild enlargement of the thyroid gland. from Laboratory there were an
increased level of free T4 and decreased levels of TSHs. However, in these patients found no
clinical symptoms of hyperthyroidism only found elevated levels of FT3 and FT4 and TSH
levels decrease. Patients underwent termination of pregnancy perabdominam with caessarea
section and given tyrozol 1x10 mg for hyperthyroidism from internal medicine Division.

Discusion
Eutyroid condition that occurs in patients after Ceassarea section suggests that the placenta as
a source of stimulation which causes the increase in thyroid activity that cause hyperthyroid
condition, so it is not necessary antithyroid drug therapy continuously.

Conclusion
hyperthyroidism is a hormonal disease in the process of forming a variety of reasons. Thyroid
disease in pregnant women should get a strict control to avoid complications that can threaten
the mother and the baby. Which used to be an effective treatment with minimal dose to avoid
adverse effects on the fetus. Therefore, its use must be very careful. there is no absolute
contraindication due to pregnancy with hyperthyroid, but the mother should receive an
explanation of complication while she was pregnant The prognosis of patients is ad bonam.

Keywords: hyperthyroidism, preeclampsia, pregnancy, FT4, TSHs.

Reference

1. Alex Stagnaro-Green, et.al. Guidelines of the American Thyroid Association for the
Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum.
Thyroid 2011;21(10):1081-1121.
2. Meczekalski B, Czyzyk A. Hyperthyroidism in pregnancy. Diagnosis and
management. Archives of Perinatal Medicine 2009;15(3):127-135
 Kehamilan Dengan Hipertiroid

Dr.dr. Mohd. Andalas, SpOG. FMAS*, Lutfi**, Indra**

*Departemen Obstetri & Ginekologi
**PPDS Obstetri & Ginekologi
***PPDS Obstetri & Ginekologi

Fakultasi Kedokteran USYIAH/ FKUI

RSUD Zainoel Abidin
Abstrak
Pendahuluan
Kehamilan dengan hipertiroid diperkirakan 2 : 1000 dari semua kehamilan,namun bila tidak
terkontrol dapat menimbulkan krisis tiroid, persalinan prematur, abortus dan kematian janin.
Diagnosis hipertiroid dalam kehamilan sulit ditegakkan karena kehamilan itu sendiri
menyebabkan perubahan-perubahan fisiologik yang menyerupai keadaan hipertiroid. Namun
deteksi dini untuk mengetahui adanya hipertiroid pada wanita hamil sangatlah penting,
karena kehamilan itu sendiri merupakan suatu stres bagi ibu apalagi bila disertai dengan
keadaan hipertiroid.

Kasus
Telah dilaporkan seorang perempuan umur 35 tahun dengan Preeklampsia berat dan
Hipertiroid G5P4A0 Hamil 40-41 minggu, Janin presentasi kepala tunggal hidup, servix
belum matang belum inpartu. Diagnosis hipertiroid pada kehamilan ini berdasarkan
anamnesa, pemeriksaan fisik, laboratorium. Ditemukan kelemahan badan, jantung berdebar,
berkeringat banyak, serta tanda takikardi dan pembesaran ringan kelenjar tiroid. Pemeriksaan
laboratorium terdapat peningkatan kadar T4 bebas serta penurunan kadar TSHs. Akan tetapi
pada pasien ini tidak ditemukan gejala klinis hipertiroid hanya ditemukan peningkatan kadar
FT4 dan FT3 dan penurunan kadar TSH. Pasien dilakukan terminasi kehamilan dengan
seksio Caessarea dan diberikan tyrozol 1x10 mg untuk hipertiroid dari divisi Ilmu penyakit
dalam.

Diskusi
Kondisi eutyroid yang terjadi pada penderita setelah operasi Seksio Ceassarea mengesankan
bahwa plasenta sebagai sumber stimulasi peningkatan fungsi tiroid yang menyebabkan
kondisi hipertiroid, sehingga tidak diperlukan terapi obat antitiroid secara terus menerus.

Kesimpulan
Penyakit tiroid pada ibu hamil selayaknya untuk mendapat kontrol yang ketat untuk
menghindari kompikasi yang dapat mengancam si ibu dan kandungannya. Pengobatan yang
digunakan harus efektif dengan dosis seminimal mungkin untuk menghindari efek samping
pada janin. Oleh sebab itu penggunaanya haruslah sangat hati-hati. Tidak ada larangan
mutlak seorang hipertiroid untuk hamil, namun si Ibu harus mendapat penjelasan
kemungkinan–kemungkinan yang terjadi saat dia hamil. Prognosis penderita adalah ad
bonam.
Kata kunci: hipertiroid, preeklampsia, kehamilan, FT4, TSHs.
Daftar Pustaka
1. Alex Stagnaro-Green, et.al. Guidelines of the American Thyroid Association for the
Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum.
Thyroid 2011;21(10):1081-1121.
2. Meczekalski B, Czyzyk A. Hyperthyroidism in pregnancy. Diagnosis and
management. Archives of Perinatal Medicine 2009;15(3):127-135.