Research Day
THYROID STORM IN PREGNANCY IN A NONCOMPLIANT PATIENT
Document Type
Abstract
Date
2021
Abstract
Introduction: Thyroid disease in pregnancy is a complex endocrine disorder due to inherent maternal physiologic changes. Hyperthyroidism is relatively rare in pregnancy with an incidence of 0.2%, thyroid storm is even more rare without an exact incidence. It can advance quickly, dangerously, and fatally to thyroid storm if not managed properly by physician and patient. Due to its rarity, quick identification and treatment are imminently important to maternal and fetal well-being.
Case Description: A multiparous 24-year-old G3P202 was diagnosed with Graves' disease, a form of hyperthyroidism, at 16 weeks gestation. The patient presented with thyroid storm at 25 weeks of gestation following a period of noncompliance. Due to escalating concern for maternal and fetal morbidity and mortality in the setting of a thyroid storm, the patient was admitted to medicine for aggressive management. Initial continuous external fetal monitoring was warranted with noted fetal tachycardia. The patient received standard doses of propylthiouracil, hydrocortisone, and propranolol. With appropriate treatment regimen, maternal and fetal status improved throughout the remainder of her two-day admission. She was discharged in stable condition on methimazole with further outpatient management of Graves' disease involving coordination among obstetrics and endocrinology.
Conclusion: Hyperthyroidism can be complicated by thyroid storm with severe, and possibly fatal, maternal or fetal outcomes. Therefore, early recognition and treatment, extensive counseling, and involvement of the entire healthcare team, are vitally important to patient outcomes.