Undiagnosed Hypothyroidism in Pregnancy Leading to Myxedema Coma in labor: Diagnosing and managing this rare Emergency
Nilanchali Singh*, Reva Tripathi, Mala YM and Divya Verma
Department of Obstetrics and Gynaecology, Maulana Azad Medical College & assoc. Lok Nayak Hospital, New Delhi, India
- Corresponding Author:
- Nilanchali Singh
Department of Obstetrics and Gynaecology
Maulana Azad Medical College & assoc. Lok Nayak Hospital, New Delhi, India
E-mail: [email protected]
Received January 27, 2016; Accepted April 28, 2016; Published April 30, 2016
Citation: Singh N, Tripathi R, Mala YM, Verma D (2016) Undiagnosed Hypothyroidism in Pregnancy Leading to Myxedema Coma in labor: Diagnosing and managing this rare Emergency. J Preg Child Health 3:247. doi:10.4172/2376-127X.1000247
Copyright: © 2016 Singh N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Myxedema crisis is an extreme complication of uncontrolled hypothyroidism. It is usually seen in elderly women with undiagnosed hypothyroidism and is rare among young. There have been very few reports of myxedema coma in labor. This report pertains to a case of undiagnosed hypothyroidism in a 30 year old lady with twin pregnancy which led to hypothyroidism crisis during labor. Levothyroxine 100 microgram was given by Ryle’s tube followed by 8 hourly doses till total dose of 900 microgram. Rapid and robust correction of hypothyroidism led to successful treatment outcome. Treatment requires a rapidly administered oral or parenteral loading dose and high maintenance doses of levothyroxine. She delivered vaginally and both the babies were fine. Maintenance dose of 100 ugm of levothyroxine was started and patient was discharged after 15 days of delivery with an advice of 100 micrograms of levothyroxine daily.