Features of pregnancy management in a patient with recurrent miscarriage and post-traumatic stress disorder complicated by thyroid dysfunction: a clinical case
DOI:
https://doi.org/10.15574/PP.2024.98.128Keywords:
recurrent miscarriage, post-traumatic stress disorder, thyroid dysfunction, autoimmune thyroiditisAbstract
Recurrent Pregnancy Loss (RPL) remains one of the acute issues in modern obstetrics and gynecology. The etiology and causes of each pregnancy loss often cannot be identified. In Ukraine, a significant number of women of reproductive age have thyroid gland dysfunction, which requires attention to this problem not only from endocrinologists but also from gynecologists, especially in managing patients with unexplained RPL.
The aim was to study the etiology of RPL based on a clinical case study and to find out the relationship between certain types of endocrine dysfunction and post-traumatic stress disorder (PTSD), which in turn can significantly increase the risk of developing RPL. Such research is important for a deeper understanding of the causes and factors that increase the risks of RPL, allowing for more effective diagnostics and treatment in planning subsequent pregnancies for women at risk of miscarriage who have been diagnosed with PTSD.
Clinical case. The patient, a 27-year-old woman, was diagnosed with RPL after the loss of her third pregnancy. During her second unsuccessful pregnancy in 2020, she was diagnosed with autoimmune thyroiditis. In 2022, she experienced another pregnancy loss at 6 weeks during the occupation of the Kyiv region. Examinations revealed thyroid dysfunction, iron deficiency anemia, and PTSD. Comprehensive treatment and preconception preparation were conducted, including medication, psychotherapy, and health monitoring. The next pregnancy, confirmed in February 2023, resulted in a successful delivery in October 2023.
Conclusions. The clinical case presented demonstrates the necessity of detailed patient history collection in patients with RPL with mandatory assessment of thyroid function and consideration of psychological status. It also highlights the importance of correcting TSH levels already at the preconception stage, without waiting for early complications or threats to pregnancy.
The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained for the study.
No conflict of interests was declared by the authors.
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