HIPERTIROID PADA KEHAMILAN MOLA HIDATIDOSA

Erwin Pangkahila, Karel Pandelaki

Abstract


Abstract: We reported a suspected pregnancy associated with 2-month-vaginal bleeding in a 42-year-old female. She was diagnosed with hyperthyroidism associated with mola hydatidosa. The diagnosis of hyperthyroidism was based on anamnesis, and physical, labo-ratory, and radiological examinations. We found palpitation, weakness, loss of weight, much sweating, tachicardia, and some enlargement of the thyroid glands. The laboratory examina-tion  showed an increase of hCG and free T4, in addition to a decrease of TSHs. In the USG examination we found a snow-like pattern. The histopathological examination showed avas-cularization with hydrophic degeneration of the villi,  and cysterna formation, all of which concluded that it was a mola hydatidosa pregnancy. The patient was treated with PTU 100 mg and propanolol 10 mg three times daily for the hyperthyroidism, and a total hysterectomy operation for the mola hydatidosa pregnancy. Prognosis of the patient was dubious.

Key words: hyperthyroid, mola hydatidosa, hCG, FT4, TSHs.

 

 

Abstrak: Telah dilaporkan seorang perempuan umur 42 tahun dengan dugaan kehamilan dan mengalami perdarahan  jalan lahir sejak dua bulan lalu, yang kemudian didiagnosis dengan hipertiroid pada mola hidatidosa. Diagnosis hipertiroid pada kehamilan mola hidatidosa dite-gakkan berdasarkan anamnesa, pemeriksaan fisik, laboratorium dan radiologi. Ditemukan ge-jala jantung berdebar, kelemahan badan, penurunan berat badan dan berkeringat banyak, serta tanda takikardi dan pembesaran ringan kelenjar tiroid.  Pemeriksaan laboratorium terdapat pe-ningkatan kadar hCG dan  T4 bebas serta penurunan kadar TSHs. Pemeriksaan USG tampak gambaran snow-like pattern dan histopatologi terdapat vili yang alami degenerasi hidropik, avaskuler dengan pembentukan sisterna yang menyimpulkan suatu kehamilan mola hidati-dosa. Pengobatan dengan pemberian PTU 100 mg dan propanolol 10 mg, kedua-duanya  tiga kali sehari untuk penanganan hipertiroid, serta dilakukan tindakan operasi histerektomi totalis untuk penanganan kehamilan mola hidatidosanya. Prognosis penderita adalah dubia.

Kata kunci: hipertiroid, mola hidatidosa, hCG, FT4, TSHs.


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DOI: https://doi.org/10.35790/jbm.1.2.2009.826

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