UDC  618.03-06:616.441-002-073.7:612.882.3

Background. Maternal thyroid dysfunction, including euthyroid goiter and subclinical hypothyroidism, is associated with complications of pregnancy mediated through placental insufficiency. Alterations in placental structure and uteroplacental and fetoplacental hemodynamics represent a possible mechanism linking thyroid disease to adverse perinatal outcomes.

Summary of work. A total of 164 pregnant women were examined by ultrasound placentography and Doppler mapping of the mother–placenta–fetus system. Group I included women with euthyroid goiter, Group II — with subclinical hypothyroidism and diffuse goiter, Group III — controls without thyroid disease. Placental maturation, localization and pathology were assessed, together with uterine and umbilical artery S/D ratios, uterine artery resistance index, and pulsatile index in the fetal aorta and middle cerebral artery.

Summary of Results. Structural placental abnormalities and discordant maturation occurred in nearly half of women with thyroid disease but were absent in controls. Premature maturation predominated in euthyroidism, while delayed maturation predominated in subclinical hypothyroidism. Doppler assessment revealed increased resistance and S/D ratios in the uterine arteries in both thyroid-disease groups, especially in subclinical hypothyroidism and on the placentation side. Peripheral placental resistance increased with gestation. Cerebral fetal indices remained largely compensated.

Discussion and Conclusion. Maternal thyroid dysfunction is associated with a high frequency of placental structural changes and impaired uterine perfusion. These hemodynamic changes likely reflect trophoblastic invasion defects and microvascular dystrophy in thyroid disease. Doppler findings enable early identification of placental insufficiency and inform preventive perinatal strategies in this at-risk population.

Take-home Messages. Thyroid disease in pregnancy is strongly associated with placental structural and hemodynamic abnormalities.

Subclinical hypothyroidism shows clinically significant Doppler impairment.

Doppler surveillance allows early prediction of placental insufficiency in thyroid-affected pregnancies.

Hyperthyroidism is a state of thyroid hormone excess, which increases the metabolic rate and causes symptoms including anxiety and tremor. Graves’ disease is the most common etiology in developed countries. Excessive levels of thyroid hormones can impact mood, energy levels, and overall well-being. It is crucial to differentiate between symptoms related to thyroid function and clinical depression. The purpose of the study was to investigate the neurological and psycho-emotional manifestations of hyperthyroidism during pregnancy. 

Materials and methods. An examination of 50 pregnant women with subclinical and overt hyperthyroidism and 20 healthy women (control group) in the second trimester of pregnancy using the method of standardized multivariate personality study was carried out. 

Results. Based on the results of the study, it can be argued that pregnant women with thyrotoxicosis have changes in the psycho-emotional sphere: psychological maladaptation to the disease, an increase in the level of anxiety with hypochondriac tendencies, neuroticism, a decrease in intellectual performance and activity, a pronounced feeling of depression, anxiety, low mood. The identified criteria allow us to attribute these changes to the personality pattern or to the manifestations of a pathological neurotic state in conditions of mal­adaptation. The specific condition and behavior of pregnant women with thyrotoxicosis requires timely diagnosis and appropriate correction, which will contribute to the normalization and improvement of the psychological state, prevent the development of chronic stress and the occurrence of perinatal complications. Conclusions. Pregnant women with thyrotoxicosis have changes in the psycho-emotional sphere: psychological maladaptation to the disease, an increase in the level of anxiety with hypochondriac tendencies, neuroticism, a decrease in intellectual performance and activity, a pronounced feeling of depression and anxiety.

UDC  618.03-06:616.441-002-073.7:612.882.3

We examined 164 pregnant women who were divided into three groups. Group I included 76 pregnant women (46.4 %) with euthyroid goiter of I–II degree. Group II consisted of 63 pregnant women (38.4 %) with subclini¬cal hypothyroidism and diffuse thyroid goiter of I–II degree. Group III was the controls and consisted of 25 (15.2 %) pregnant women without thyroid pathology. The placenta was studied with the characteristics of ultrasound placentography, placental maturation disorders, the area and localization were determined, and pathological changes in the placental tissue were detected. Changes in the systolic-diastolic ratio in the uterine arteries and umbilical cord arteries were assessed, the resistance index in the uterine arteries, the pulsatile index in the fetal aorta and middle cerebral artery were determined using the method of color Doppler mapping of blood flow in the mother-placenta-fetus system. Study of the echographic picture of structural changes in the placenta revealed a significant impairment of its maturation, especially in the group with euthyroidism. Ultrasound screening revealed that in every second pregnant woman with thyroid disease, the condition of the placenta did not correspond to the gestational age, there were swelling, cysts and placental infarctions, a high frequency of diffuse changes in placental tissue, and hyperechogenic inclusions in the amniotic fluid. An increase in the resistance index in the uterine arteries of pregnant women, especially those with subclinical hypothyroidism, is noteworthy. With increasing gestational age, the peripheral resistance of the placental microvasculature increases due to involutional-dystrophic changes and circulatory disorders, which allows us to develop criteria for the prognosis and diagnosis of placental dysfunction, and to prevent perinatal disorders in pregnant women with thyroid disease.

UDC  618.03-06:616.441-002-073.7:612.882.3

Thyroid disease is the second most common endocrine disorder after diabetes inpregnancy.Thyroidhormonesarecrucialforthegrowthandmaturationofmanytargettissues,especiallythebrain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential forfetal development as it supplies thyroid hormone-dependent tissues. The purpose of the study was to researchthe features of the bioelectrical activity of the brain in pregnant women with thyroid pathology and determine thefrequency of such changes. Materials and methods.The state of bioelectrical activity of the brain was evaluatedby electroencephalography in 160 pregnant women with thyroid pathology. The biopotentials of the brain in thesubjects were studied with software and hardware complex DX-NT32 (DX Complexes software, Kharkiv, Ukraine)and computer processing of electroencephalography data. Electrodes in the amount of 16 pieces were appliedaccording to the international scheme 10/20 in the bipolar interpretation. Results. Specific changes in electro-encephalograms characteristic of each type of thyroid pathology and dependent on its severity were revealed inpregnant women. Acquired disorders adversely affect the course of pregnancy and childbirth in women with thyroidpathology. Increased anxiety with depressive tendencies, reduced general activity, a feeling of depression, anxiety,and low mood were detected in women with thyroid disorders. The identified criteria make it possible to attributethese changes to the manifestations of a pathological neurotic state in conditions of maladaptation, which wasconfirmed by electroencephalography data. Conclusions. The detected disorders of spontaneous and evokedbrain activity indicate the existence of a cerebral basis of psychological stress, which has a qualitative effect onelectroencephalography. Acquired disorders negatively affect the course of pregnancy, childbirth, perinatal out-comes, and future development of the child.Keywords:pregnant women; thyroid gland; diffuse non-toxic goiter; diffuse toxic goiter; electroencephalography