[Thyreopathy examination during pregnancy--results of pilot project]. / Soucasné zkusenosti s vysetrováním tyreopatií v gravidite--výsledky pilotního projektu.

ABSTRACT

BACKGROUND: This Pilot Project (PP), sponsored by the Preventative Department of the General Health Insurance Company, was carried out in the Czech Republic in 2009. The aim was to assess the feasibility of applying selected thyroid tests in all women in the first trimester of pregnancy, and evaluate the results. METHODS: The project arose from the fact that the normal function of the thyroid ensures that pregnancy takes it proper course, and that sufficient level of thyroxin is necessary for healthy foetus development. Thyroid disorders are quite frequent among fertile women. In a group of 2937 asymptomatical pregnant women in their 9th-11th week, thyroid blood tests were carried out (TSH, FT4 and TPOab). The choice of those three indicators is optimal for the diagnosis of thyroid dysfunction in pregnancy. It was possible to time the tests and the blood tests intended to diagnose genetic disorders. RESULTS: In a total of 109 women FT4 levels were lower; in such cases brain development is endangered and there is a risk of poor psychomotor development of the child. Higher TSH had 228 women and in these cases the thyroid function is sub-optimal. The presence of TPOab in 262 women indicates that the thyroid is not able to adapt well to the increased demands during the pregnancy. CONCLUSIONS: The Pilot Project proved that a minimum of 7-10% of pregnant women have no knowledge of the fact that they have some kind of thyroid disorders. The project was carried out for the first time in the Czech Republic, and resulted in important information and confirmation of the benefits of the chosen approach.