scholarly journals Study of thyroid function in pregnancy, its feto-maternal outcome; a prospective observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kalpana Mahadik ◽  
Payal Choudhary ◽  
P. K. Roy
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Subclinical Hypothyroidism ◽  
Prospective Observational Study ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
History Of ◽  
Thyroid Profile ◽  
In Pregnancy

Abstract Background Pregnancy is a stress test of maternal thyroid function. The prevalence of thyroid dysfunction in pregnant women is high. Subclinical hypothyroidism occurs in 10% of all pregnancies. Effects of hypothyroidism in pregnancy are anemia, low birth weight and mental retardation in neonate. This study is aimed to evaluate maternal and fetal outcomes in pregnant women with deranged thyroid profile. The relevance of this study is to document the association of hypothyroidism and its adverse effects on mother and fetus. Methods This prospective observational study was carried out at R.D. Gardi Medical College, Ujjain, India. Subjects of this study were 198 antenatal women in third trimester with singleton pregnancy admitted in the obstetric ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residence and socioeconomic status. Women with multiple pregnancy, a known case of thyroid disorder, or any pre-existing medical disorder were excluded. Routine hematological parameters and estimation of T3, T4 and TSH was conducted. Patients with deranged thyroid profile were subsequently assessed for maternal and fetal complications. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion, hemoglobin level and fetal outcome were the main study variables. Data was analysed in SPSS software for statistical co-relation. Results Prevalence of thyroid disorder is 11%; with subclinical hypothyroidism, overt hypothyroidism and subclinical hyperthyroidism occurring in 5.6, 3.5 and 1.5% of subjects respectively. In women with subclinical and overt hypothyroidism, anemia was present in 26.3% being significantly associated with hypothyroidism (p = 0.008). With respect to fetal outcome, LBW 31.6% (p = 0.001), NICU admission 42.1%, (p = 0.000) and low APGAR Score (21.1%, p = 0.042) were statistically associated with hypothyroidism. Risk of anemia, Low Birth weight, NICU admissions, and low APGAR score was 4.8, 6.3, 0.14 and 3.64 times higher respectively in women with hypothyroidism than in women who are euthyroid. Conclusion Prevalence of subclinical hypothyroidism is 5.6% in 3rd trimester of pregnancy. Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism.

scholarly journals Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

2015 ◽  
Vol 40 (2) ◽  
pp. 52-57 ◽  
Author(s):  
M Sharmeen ◽  
PA Shamsunnahar ◽  
TR Laita ◽  
SB Chowdhury
Keyword(s):  
Adverse Effects ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Adequate Treatment ◽  
In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

scholarly journals Prevalence of thyroid disorders in pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3493
Author(s):  
Sangeeta Pahwa ◽  
Sabia Mangat
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Screening ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

AN EPIDEMIOLOGICAL STUDY ON THE PREVALENCE OF HYPOTHYROIDISM IN PREGNANT WOMEN AND ITS OUTCOME

2021 ◽  
pp. 48-50
Author(s):  
Vinita singh ◽  
Sneha kumari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Neonatal Outcome ◽  
Reproductive Age ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
Neonatal Complications ◽  
In Pregnancy

Thyroid disorders are the most common endocrine disorders affecting women of reproductive age group Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% Maternal hypothyroidism leads to many maternal and perinatal complications like miscarriage, gestational diabetes mellitus, pre-eclampsia, pre-term labor, placental abruption, and fetal death. AIMS AND OBJECTIVE: To nd out the effect of hypothyroidism on the course of pregnancy, to study the neonatal outcome, to know the prevalence of subclinical and overt hypothyroidism in pregnant women. MATERIALS AND METHODS: This prospective study was conducted in the department of Obstetrics and Gynecology, Nalanda medical college and hospital, Patna. All pregnant women attending the obstetric unit during this period were included in the study after informed consent 10 ml of blood sample of pregnant women was drawn at the rst visit in the rst trimester; then it was centrifuged and stored at -70 degree Celsius until assays, which were done after delivery, TFT was assessed by quantitative analysis of serum TSH and FT4 (ELISA). The pregnancy outcome variables like miscarriages, preterm deliveries, IUGR, preeclampsia, anemia, low birth weight, intrauterine fetal demise, antepartum hemorrhage, stillbirth, postpartum hemorrhage, birth asphyxia were studied. The neonatal outcome was also studied. The statistical analysis was done using the odds ratio. P-value <0.05 was considered signicant. RESULTS: Out of the 250 pregnant women 25 had hypothyroidism (9.5%). The prevalence of subclinical hypothyroidism was more as compared to the overtone (Table 2). Abortions were seen in 12.5% of subclinical and 11.1% of overt hypothyroid women. PIH and abruptions were signicantly higher in subclinical cases (P<0.05) while in the overt group both complications were higher as compared to the normal women but the p-value was not signicant for abruption. More of the hypothyroid women had preterm delivery (37.5% in subclinical and 44.4% in the overt group), Regarding neonatal complications, IUD and Early neonatal deaths were signicantly higher in overt hypothyroidism (P<0.01) Hypothyroid women had more low birth weight babies (31.25% in subclinical and 35.5% in overt) and IUGR babies (18.70% in subclinical and 22.21% in overt), CONCLUSION: The present study shows that, though the occurrence of hypothyroidism in pregnancy is less yet it causes many maternal and neonatal complications therefore universal screening of thyroid disorder should be done in pregnancy.

scholarly journals Prevalence of overt and subclinical thyroid dysfunction among women and its effects on maternal and fetal outcome

2018 ◽  
Vol 7 (6) ◽  
pp. 2123
Author(s):  
Puja Kumari ◽  
Sadhana Singh
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Growth Retardation ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Intrauterine Growth Retardation ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Intrauterine Growth

Background: Objective of present study was to determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome.Methods: 400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted.Results: The prevalence of hypothyroidism and hyperthyroidism was and 1.25%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8%) and placental abruption (16.6 vs. 0.8%). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8%) as compared to the euthyroid patients. Adverse fetal outcome in overt hypothyroidism  included spontaneous abortion (16.6 vs. 2.39%), preterm birth (33.3 vs. 5.8%), low birth weight (50 vs. 12.11%), intrauterine growth retardation (25 vs. 4.9%), and fetal death (16.6 vs.7%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39%), preterm delivery (11.2 vs. 5.8%), low birth weight (25 vs. 12.11%), and intrauterine growth retardation (8.4 vs. 4.9%) as compared to the euthyroid women.Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

scholarly journals Thyroid disorder in antenatal women in sub-himalayan region: a need for universal screening

2017 ◽  
Vol 6 (8) ◽  
pp. 3445
Author(s):  
Swati Dubey ◽  
Anup Pradhan
Keyword(s):  
Gestational Age ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Fetal Outcome ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
Adverse Pregnancy ◽  
Pregnant State ◽  
In Pregnancy

Background: Thyroid dysfunction constitutes the second most common endocrine disorder of pregnancy, associated with adverse maternal and fetal outcome and is often overlooked in pregnancy due to their nonspecific symptoms and the hypermetabolic pregnant state. Objective of present study was to establish the prevalence of thyroid dysfunction, study the effects in pregnancy in sub-himalayan population and whether universal screening for thyroid dysfunction is required.Methods: The study was conducted on 200 patients in the age group of 20 to 35 years with a singleton pregnancy and gestational age between 6 to 24 weeks.Results: In the 200 women screened, the prevalence of thyroid dysfunction was found to be 14% with 8% having subclinical hypothyroidism while an equal percentage of 2% having clinical hypothyroidism, subclinical hyperthyroidism and clinical hyperthyroidism. The mean age of patients with subclinical hypothyroidism was 28.6 ± 4.9 years, with thyroid disorder in pregnancy being significantly more common in primigravida. Statistically significant association was found between patients with thyroid dysfunction and abortions, preeclampsia, preterm labor, small for gestational age, low birth weight, and admission to NICU.Conclusions: Prevalence of thyroid dysfunction was found to be high in our study, particularly subclinical hypothyroidism and was associated with adverse pregnancy outcomes; hence, more research is required in the Sub-Himalayan goitre belt to assess the magnitude of the problem and formulate universal screening protocols in this particular subset of the Indian population accordingly.

scholarly journals Prevalence of thyroid dysfunction and impact on maternal and fetal outcome in Central Indian pregnant women

2017 ◽  
Vol 6 (10) ◽  
pp. 4666
Author(s):  
Joysee Pokhanna ◽  
Urvi Gupta ◽  
Madhuri Alwani ◽  
Shruti Pathak Tiwari
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Growth Retardation ◽  
Thyroid Dysfunction ◽  
Intrauterine Growth Retardation ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Fetal Outcomes ◽  
Intrauterine Growth ◽  
In Pregnancy

Introduction: Thyroid dysfunctions have become common endocrine problems in pregnant women. It is now well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are very few data from India about the prevalence of thyroid dysfunction in pregnancy. In this study, we determined the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Central Indian Indore Pregnant Women.Methods: Total 300 pregnant women between the 13 and 26 weeks of gestation were recruited for this study who is residing in Indore. In all patients routine obstetrical investigations, TSH tests were done. Anti-TPO antibody tests and Free T4 were done in patients with deranged TSH. The obstetrical and perinatal outcomes were recorded. Almost all the patients were followed up to delivery.Results: The prevalence of hypothyroidism and hyperthyroidism was 13 and 4%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (22.2 versus 11.6%) and placental abruption (22.2 versus 2.0%). Subclinical hypothyroidism was associated with preeclampsia (30.0 versus 11.6%) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (22.2 versus 6.6%), preterm birth (44.4 versus 30.0%), low birth weight (66.6 versus 30.0%), intrauterine growth retardation (33.3 versus 10.0%), and fetal death (22.2 versus 0%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (2.0 versus 6.6%), preterm delivery (5.2 versus 30.0%), low birth weight (11.2 versus 30.0%), and intrauterine growth retardation (4.4 versus 10 %) as compared to the euthyroid women.Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

scholarly journals Prevalence and complications of hypothyroidism during pregnancy in western Uttar Pradesh

2021 ◽  
Vol 10 (2) ◽  
pp. 632
Author(s):  
Karishma Chaudhary ◽  
Poonam Mani ◽  
Lalita Yadav ◽  
Mamta Tyagi
Keyword(s):  
Subclinical Hypothyroidism ◽  
Uttar Pradesh ◽  
Thyroid Function Test ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
Timely Initiation ◽  
Entire Pregnancy ◽  
Maternal Thyroid ◽  
Complications Rate

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Uttar Pradesh and its potential complications. A prospective and comparative clinical study to know prevalence of thyroid disorder in pregnancy and pregnancy outcome was done.Methods: Eight Hundred eighty seven pregnant cases from Department of Obstetrics and Gynaecology, Chattrapati Shivaji Subharti Hospital, Meerut were enrolled in the study from the year 2018 to 2020. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4, TSH and Anti-TPO) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Thirty seven patients dropped out from the study.Results: In this study, prevalence of thyroid disorder was 27.28% which was high when compared to other regions in India and in other parts of Asia. Subclinical hypothyroidism and Overt hypothyroidism was 16.57% and 10.71% respectively. Subclinical hypothyroidism was more prevalent and hidden, leading to the poor obstetrical outcome and fetal complications. Rate of miscarriage was high in overt hypothyroid patients.Conclusions: Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

scholarly journals Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

2021 ◽  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Hellp Syndrome ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Maternal Mortality Rate ◽  
In Pregnancy

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.

scholarly journals A prospective observational study to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility

2021 ◽  
Vol 10 (11) ◽  
pp. 4272
Author(s):  
Vinitha Dharmalingam ◽  
R. Kala
Keyword(s):  
Observational Study ◽  
Visual Impairment ◽  
Prospective Observational Study ◽  
Hypertensive Retinopathy ◽  
Pregnancy Induced Hypertension ◽  
Choroidal Ischemia ◽  
Induced Hypertension ◽  
Changes In Pregnancy ◽  
The Relationship ◽  
In Pregnancy

Background: Irreversible visual impairment and morbidity are associated with pregnancy induced hypertension. It causes pathological changes in vascularity of placenta, kidney and brain along with two major pathological types of changes in fundus namely arteriolar vasospasm and permeability changes in vascular endothelium. The aim of our study was to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility.Methods: A prospective observational study done on pregnant women with any grade of pregnancy induced hypertension with recent visual impairment from 24 completed weeks of pregnancy.Results: Out of 75 patients with PIH, all the patients had varying degree of fundus changes in one or both eyes. In 150 eyes of the 75 patients, 86 (57.30%) eyes had isolated arteriolar vasospasm, 14 (9.33%) had grade III hypertensive retinopathy, 4 (2.66%) had grade IV hypertensive retinopathy, 30 (20%) had macular oedema, 4 (2.66%) had central serous chorioretinopathy, 2 (1.33%) had vascular occlusion, 2 (2.66%) eyes had normal fundus with cortical blindness, 2 (2.66%) had exudative retinal detachment, 6 (4%) eyes had normal fundus with changes in the other eye.Conclusions: Out of 75 patients, 7 (9.3%) patients had irreversible loss of vision, 3 (42.85%) due to arteriolar vasospasm, and 4 (57.15%) due to choroidal ischemia. Among the 4 patients with choroidal ischemia, 3 (75%) were in the group of eclampsia and 1 (25%) in gestational hypertension.

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