Evaluation of thyroid nodule diagnosed during pregnancy

ABSTRACT

This study was undertaken to evaluate the course and manage thyroid nodules and also to estimate the changes in thyroid functional status levels among pregnant women. Thirty-two pregnant women with thyroid nodules were examined by ultrasound [US] and biopsed by fine needle aspiration [FNA] for cytopathological and immunohistochemical [IHC] phenotyping using antibodies for thyroglobulin [Tg] and calcitonin. Serum samples were obtained and thyroid stimulating hormone [TSH], free T4, T3, Tg, calcitonin and human chorionic gonadotropin [beta- hCG] were assessed. US showed that 19 [59.4%] of the 32 patients had multiple colloid nodular goitre with a dominant clinically palpable nodule, while 13 [40.6%] of patients had true solitary thyroid nodules. The true solitary thyroid nodules were as follows; two well-differentiated papillary carcinoma, one Hashimoto's disease and 10 as benign colloid follicular adenomas. Patients with thyroid nodules had lower serum TSH and higher Tg levels at 1st trimester. Appearance of new thyroid nodules were detected in 4 [12.5%] women as pregnancy advanced. Compared with control group subjects with thyroid nodules had higher urinary iodine excretion. No difference could be detected in TSH and Tg levels throughout pregnancy between women with preexisting or newly formed nodules. Beta-hCG showed a positive relationship with fT3, fT4, and inversely related Tg and TSH