الفهرس 
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Abstract
The study was carried out on 60 pregnant women who presented at OB/GYN department of Sohag university hospital during 6 months from January to July 2018 (30 preeclamptic as study and 30 normal pregnancies as control).
The results of the present study suggest that thyroid diseases are predisposing factors for development of preeclampsia because there is association between thyroid abnormalities and pregnancy caused hypertension.
statistically significant higher numbers of preeclamptic women who has abnormally high TSH levels (subclinical hypothyroidism) about (44.8%) as compared to (7%) in control group. TSH is above 5μIu/ml, could be a risk of developing preeclampsia is 4-5 times higher. The fT3 levels were higher in preeclampsia as compared to normotensive pregnant patients but The fT4 levels were slightly lower in preeclampsia as compared to normotensive pregnant patients, this fall was observed only in the severe form of preeclampsia and not in the mild form of preeclampsia.
Variation of thyroid functioning later in life may develop in preeclampsia women. Thus, it suggests that thyroid function test may be necessary for screening for prediction of preeclampsia during early pregnancy and after parturition. The measurement of fT4 and TSH, provides the most accurate assessment of thyroid function. (166) The difference of our study with other findings could be related to different geographical areas, races and diets.
This relation between preeclampsia and subclinical hypothyroidism was explained in previous studies as Pregnancy is generally associated with hypothyroxinemia and the degree of hypothyroxinemia might reflect the severity of Preeclampsia.
The Summary
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On the other hand, lower fT3 levels in preeclampsia as compared to normotensive pregnant have been reported in the literature (167).
Placental dysfunction may cause failure in estrogen production, leading to a decrease in TBG, TT3 and TT4 levels (162).TBG is reported to be lower in unsuccessful pregnancies indicating placental function deterioration in pregnancy(167). Also, low TBG, TT4 and TT3 levels have been reported in preeclampsia, which was attributed to placental dysfunction in preeclamptic women (27).
There is no debate in regard to treating pregnant women who are hypothyroid; however, but detecting and treating women with elevated TSH and normal T4 levels (subclinical hypothyroidism) is controversial. (166)
CONCLUSION
In the present study TSH levels were higher in preeclampsia subjects compared to normal pregnant women, which could indicate the possible etiology for preeclampsia.
Elevated TSH levels could be used as predictor of preeclampsia. Women who develop preeclampsia are more like to have decreased thyroid function. Thyroid function screening should be done in first trimester of pregnancy for early diagnosis and treatment of preeclampsia to prevent further complication of it.
Measurement of T4 and TSH, provides the most accurate assessment of thyroid function. The difference of our study with other findings could be related to different geographical areas, races and diets.
RECOMMENDATIONS
In the present study TSH levels were higher in preeclampsia subjects compared to normal pregnant women, which could indicate the possible etiology for preeclampsia. Elevated TSH levels could be used as predictor of preeclampsia. Women who develop preeclampsia are more like to have decreased thyroid function.
Thyroid function screening should be done in first trimester of pregnancy for early diagnosis and treatment of preeclampsia to prevent its further complication.
This high risk is potent marker to develop preeclampsia needs further studies on a large sample size to support our findings and further research is needed to find out if treatment of thyroid dysfunction early in pregnancy will change the course of preeclampsia and lower the incidence and severity of morbidity and mortality associated with preeclampsia.
A multicenter study may help to find the association and mechanism of thyroid abnormalities in preeclamptic women in different geographical regions.