The assessment of fetal cardiac output in maternal hypothyroidism under levothyroxine treatment

Echocardiography. 2022 Nov;39(11):1434-1438. doi: 10.1111/echo.15474. Epub 2022 Oct 20.

Abstract

Objective: In this study, we investigated whether maternal hypothyroidism has a role in the cardiac output (CO) of the fetus or not.

Methods: Pregnant women between 33 and 37 gestational weeks known to have hypothyroidism and using levothyroxine were accepted as the case group. Gestational age-matched healthy euthyroid pregnant women constituted the control group. Fetal echocardiography was performed. Diameters and the velocity waveform of the pulmonary artery (PA) and aortic valves were measured. Velocity time integral (VTI) was also measured from the ventricular outflow tract. CO was calculated using VTI × π (Aortic Valve or Pulmonary Valve diameter/2) 2 × heart rate formula.

Results: The aortic and PA annulus were measured larger in the control group. (p = .003, p = .005, respectively). Furthermore, the right and left CO of the case group were lower than the control group. Whereas the mean combined CO (ml/min) of the case group was 674.8 ± 146.2, it was 827.8 ± 167.9 in the control group (p < .001). Additionally, a negative correlation was observed between thyroid-stimulating hormone and aortic VTI (r:-.480; p:.006).

Conclusion: The findings of our study suggest that the CO of the fetus may be affected by maternal hypothyroidism.

Keywords: cardiac output; fetal echocardiography; levothyroxine; maternal hypothyroidism.

MeSH terms

  • Cardiac Output
  • Female
  • Fetus
  • Heart Ventricles
  • Humans
  • Hypothyroidism* / complications
  • Hypothyroidism* / diagnostic imaging
  • Hypothyroidism* / drug therapy
  • Pregnancy
  • Thyroxine* / therapeutic use

Substances

  • Thyroxine