scholarly journals Pregnancy outcomes in women with severe hypothyroidism

2013 ◽  
Vol 169 (3) ◽  
pp. 313-320 ◽  
Author(s):  
Dania Hirsch ◽  
Sigal Levy ◽  
Varda Nadler ◽  
Vered Kopel ◽  
Bracha Shainberg ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Control Group ◽  
Study Group ◽  
Maximum Serum ◽  
Health Maintenance ◽  
Median Serum ◽  
The Impact ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveHypothyroidism during pregnancy has been associated with adverse obstetrical outcomes. Most studies have focused on subjects with a mild or subclinical disorder. The aims of the present study were to determine the relative rate of severe thyroid dysfunction among pregnant women with hypothyroidism, identify related factors and analyse the impact on pregnancy outcomes.DesignA retrospective case series design was employed.MethodsThe study group included 101 pregnant women (103 pregnancies) with an antenatal serum TSH level >20.0 mIU/l identified from the 2009–2010 computerised database of a health maintenance organisation. Data were collected from the medical records. Pregnancy outcomes were compared with those of a control group of 205 euthyroid pregnant women during the same period.ResultsThe study group accounted for 1.04% of all insured pregnant women with recorded hypothyroidism during the study period. Most cases had an autoimmune aetiology. All women were treated with levothyroxine (l-T4) during pregnancy. Maximum serum TSH level measured was 20.11–150 mIU/l (median 32.95 mIU/l) and median serum TSH level 0.36–75.17 mIU/l (median 7.44 mIU/l). The mean duration of hypothyroidism during pregnancy was 21.2±13.2 weeks (median 18.5 weeks); in 36 cases (34.9%), all TSH levels during pregnancy were elevated. Adverse pregnancy outcomes included abortions in 7.8% of the cases, premature deliveries in 2.9% and other complications in 14.6%, with no statistically significant differences from the control group. Median serum TSH level during pregnancy was positively correlated with the rate of abortions+premature deliveries and rate of all pregnancy-related complications (P<0.05).ConclusionsAbortions and premature deliveries occur infrequently in women with severe hypothyroidism. Intense follow-up and l-T4 treatment may improve pregnancy outcomes even when target TSH levels are not reached.

scholarly journals Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease

2018 ◽  
Vol 178 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Flora Veltri ◽  
Pierre Kleynen ◽  
Lidia Grabczan ◽  
Alexandra Salajan ◽  
Serge Rozenberg ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Pregnancy Outcomes ◽  
Thyroid Disease ◽  
Thyroid Autoimmunity ◽  
Thyroid Peroxidase ◽  
Normal Range ◽  
Baseline Characteristics ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveIn the recently revised guidelines on the management of thyroid dysfunction during pregnancy, treatment with thyroid hormone (LT4) is not recommended in women without thyroid autoimmunity (TAI) and TSH levels in the range 2.5–4.0 mIU/L, and in a recent study in that particular group of pregnant women, more complications were observed when a treatment with LT4 was given. The objective of the study was therefore to investigate whether variation in thyroid function within the normal (non-pregnant) range in women free of thyroid disease was associated with altered pregnancy outcomes?DesignCross-sectional data analysis of 1321 pregnant women nested within an ongoing prospective collection of pregnant women’s data in a single centre in Brussels, Belgium.MethodsThyroid peroxidase antibodies (TPO-abs), thyroid-stimulating hormone (TSH), free T4 (FT4) and ferritin levels were measured and baseline characteristics were recorded. Women taking LT4, with TAI and thyroid function outside the normal non-pregnant range were excluded. Pregnancy outcomes and baseline characteristics were correlated with all TSH and FT4 levels within the normal range and compared between two groups (TSH cut-off < and ≥2.5 mIU/L).ResultsTobacco use was associated with higher serum TSH levels (OR: 1.38; CI 95%: 1.08–1.74);P = 0.009. FT4 levels were inversely correlated with age and BMI (rho = −0.096 and −0.089;P < 0.001 and 0.001 respectively) and positively correlated with ferritin levels (rho = 0.097;P < 0.001). Postpartum haemorrhage (>500 mL) was inversely associated with serum FT4 levels (OR: 0.35; CI 95%: 0.13–0.96);P = 0.040. Also 10% of women free of thyroid disease had serum TSH levels ≥2.5 mIU/L.ConclusionsVariation in thyroid function during the first trimester within the normal (non-pregnant) range in women free of thyroid disease was not associated with altered pregnancy outcomes. These results add evidence to the recommendation against LT4 treatment in pregnant women with high normal TSH levels and without TPO antibodies.

scholarly journals Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Abdul Rehman Khokhar ◽  
Abdul Majeed Cheema
Keyword(s):  
Sample Size ◽  
Congenital Hypothyroidism ◽  
Case Control Study ◽  
Sampling Technique ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Serum Tsh ◽  
Control Study ◽  
Tsh Levels

Objectives: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism. Methods: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied. Results: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group. Conclusions: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan. doi: https://doi.org/10.12669/pjms.37.5.4086 How to cite this:Khokhar AR, Cheema AM. Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4086 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Xue Zhou ◽  
Ben Li ◽  
Chao Wang ◽  
Zhihong Li
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Hs Crp ◽  
The Impact

Objective: To investigate the effect of vitamin D deficiency on the levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), interleukin-1 (IL-1) and high-sensitivity C-reactive protein (hs-CRP) in pregnant women with early pregnancy complicated by subclinical hypothyroidism. Methods: A total of 172 pregnant women with subclinical hypothyroidism in the first trimester diagnosed and treated in a given hospital from August 2014 to May 2018 were selected, and their levels of vitamin D were determined. Depending on the abnormality of their vitamin D levels, the study participants were divided into two groups: the study group (vitamin D≤20 ng/L) and the control group (vitamin D>20 ng/L). The levels of TSH, TPO-Ab, IL-1 and hsCRP in the two groups were measured. Results: The levels of TSH, hsCRP and TPO-Ab in the study group were significantly higher than those in the control group (P < 0.05). The comparison between the two groups in terms of IL-1 showed no statistically significant difference. Conclusion: Vitamin D deficiency in the first trimester is associated with in an increased level of TSH in the first trimester, thereby aggravating subclinical hypothyroidism. The mechanism may be associated with the impact of vitamin D deficiency on hs-CRP and other body inflammation indicators, as well as on thyroid autoantibodies and other immune indicators, but has no effect on IL-1 levels. doi: https://doi.org/10.12669/pjms.36.6.1982 How to cite this:Zhou X, Li B, Wang C, Li Z. Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.1982 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of individualized medical nutrition guidance on pregnancy outcomes in older pregnant women

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110331
Author(s):  
Chun-Ling Li ◽  
Ying-Hua Wang ◽  
Jun-Li Wang ◽  
Ping Zhang ◽  
Yan Sun
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Pregnancy Outcomes ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Child Outcomes ◽  
Control Group ◽  
Study Group ◽  
Medical Nutrition

Objective We aimed to explore the effect of individualized medical nutrition guidance on pregnancy outcomes among older pregnant women. Methods This was a prospective study using a randomized controlled trial design. We selected 820 older pregnant women and randomly divided them into a study group and control group (410 women each). The control group was given routine health education and nutrition guidance; the study group was provided individualized medical nutrition guidance. Gestational diabetes mellitus, hypertensive disorders of pregnancy, vaginal delivery rate, postpartum hemorrhage rate, gestational body weight, neonatal birth weight, and neonate transfer to the neonatal intensive care unit (NICU) were compared between the groups. Results The incidence of gestational diabetes in the study group was significantly lower and the rate of vaginal delivery was significantly higher than those in the control group. The incidence of macrosomia, rate of neonatal transfer to the NICU, and rate of neonatal hyperbilirubinemia were significantly lower in the study group than those in the control group. Conclusions Individualized nutritional intervention for older pregnant women can effectively reduce the incidence of complications during pregnancy and childbirth and improve maternal and child outcomes.

scholarly journals How Did Prenatal Education Impact Women’s Perception of Pregnancy and Postnatal Life in a Romanian Population

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 581
Author(s):  
Anca Maria Balasoiu ◽  
Octavian Gabriel Olaru ◽  
Romina Marina Sima ◽  
Liana Ples
Keyword(s):  
Prenatal Care ◽  
Newborn Care ◽  
Control Group ◽  
Postnatal Life ◽  
Study Group ◽  
Prenatal Education ◽  
Questionnaire Online ◽  
A Prospective Study ◽  
The Impact ◽  
Official Information

Background and Objectives: Prenatal education represents an important part of maternal prenatal care in Western countries. In Romania, prenatal education is of recent interest but there is no official information about prenatal courses and their impact on prenatal care and patients in Romania. Material and methods: A prospective study based on the STROBE statement was designed in order to assess the prenatal education delivered in our unit. The study group included women who gave birth at Bucur Maternity, “Saint. John” Hospital, Bucharest, Romania and attended the prenatal courses, compared with a control group (women who gave birth in our unit but did not attend the prenatal lecture). Patients’ perception about the impact of prenatal education was collected by applying a questionnaire. Results: The analysis included 89 women who fulfilled the questionnaire online. In our study, 62 women (69.7%) attended the prenatal education classes and represented the study group while 27 women (30.3%) constituted the control group. Women who attended the prenatal lecture recognized the utility of the topic regarding newborn care (90.3%), while women from the control group did not consider it useful (n = 55.6%), χ2 = 18.412, p < 0.001. Patients from the study group admitted the importance of the topics (93.5%) from the lectures about breast feeding, while the percentage of these women from the control group is significantly lower (55.6%) χ2 = 27.867, p < 0.001. Conclusions: The benefits of prenatal education were recognized by women who attended the prenatal lecture, while women who did not participate underestimated the utility of the topics. Further actions are required to inform mothers about the necessity of antenatal education.

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

2010 ◽  
Vol 13 (5) ◽  
pp. 501-507 ◽  
Author(s):  
Ali Gedikbasi ◽  
Alpaslan Akyol ◽  
Gokhan Yildirim ◽  
Ali Ekiz ◽  
Ahmet Gul ◽  
...  
Keyword(s):  
Gestational Age ◽  
Statistical Significance ◽  
Expectant Management ◽  
Control Group ◽  
Study Group ◽  
Preliminary Evaluation ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Twin Pregnancies ◽  
Age At Birth

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n= 429; 2137g and 34.71 weeks), DC study group,n= 37; 2117g (p= .338) and 33.97 weeks (p= .311), and DC study group with major malformations,n= 30; 2019g (p= .289) and 33.3 weeks (p= .01), and showed only significance for gestational age. There was no statistical significance between MC control group,n= 86; 2097g and 34.93 weeks, and MC study group,n= 18; 2237g (p= .338), and 34.42 weeks (p= .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

scholarly journals THE EFFECT OF RECTAL PROGESTERONE ON DOPPLER PARAMETERS OF THE UTERINE ARTERIES FOR THE PREVENTION OF PRETERM DELIVERY IN IRAQI POPULATION

2018 ◽  
Vol 11 (10) ◽  
pp. 545
Author(s):  
Fatin Shallal Farhan ◽  
Ban Hadi Hameed ◽  
Muna Abdulghani Zghair
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Resistance Index ◽  
Control Group ◽  
Study Group ◽  
Duration Of Treatment ◽  
Uterine Arteries ◽  
Doppler Study ◽  
Threatened Preterm Labor ◽  
Doppler Indices

Objective: The effectiveness of progesterone in the prevention of threatened preterm labor has been established for many years, but the preferable route, dose, and duration of treatment are until now under the evaluation of researches. The aim of this study was to determine the effect of rectal progesterone on Doppler indices of the uterine arteries in pregnant women with threatened preterm delivery.Methods: A prospective case–control study was conducted at the obstetric ward and the Outpatients Department of Al-Yarmouk Teaching Hospital in Baghdad for the period of 1 year from April 1, 2017, to April 1, 2018. 100 women were enrolled in the study, 50 of them were pregnant women with a diagnosis of preterm labor assigned as a study group and the other 50 were apparently healthy pregnant women of the same gestational age assigned as a control group. Doppler study of uterine arteries was done to all participants, and the results were compared for both groups. The patients with preterm labor received nifedipine tocolysis initially until contractions subsided and Doppler study had been repeated for those women after 1 week of rectal progesterone therapy.Results: The study group had a significantly higher resistance index (RI) than the control group (0.58 vs. 0.52) as p<0.05, in spite of the pulsatility index (PI) being higher for the study group compared to the control group (0.78 vs. 0.77) but this difference was not statistically significant. The RI before the therapy (0.58) was significantly higher than the index after therapy (0.52), and the PI was again significantly higher before therapy (0.78) than after therapy (0.71) as p<0.05. During the follow-up period, 3 (6.5%), 4 (8.7), and 39 (84.8%) patients delivered within 1 week, after 1 week, and at term, respectively.Conclusion: Rectal progesterone can arrest threatened preterm labor, and this effect is possible in part explained by its action on uterine arteries.

scholarly journals Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Carina Rodrigues ◽  
Inês Baía ◽  
Rosa Domingues ◽  
Henrique Barros
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Web Of Science ◽  
Study Quality ◽  
Neonatal Deaths ◽  
Live Births ◽  
Milk Samples ◽  
The Impact

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

scholarly journals COVID-19 Quarantine is a Risk Factor for Poor Pregnancy Outcomes in GDM Patients: A Retrospective Study

2021 ◽  
Author(s):  
Qin-Yu Cai ◽  
Yin Yang ◽  
Ling-Ling Ruan ◽  
Dang-Dang Wang ◽  
Han-Lin Cui ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Electronic Medical Records ◽  
Pregnancy Outcomes ◽  
Medical Records ◽  
Control Group ◽  
Second Trimester ◽  
Public Health Emergencies ◽  
Nuchal Cord ◽  
Adverse Pregnancy ◽  
Glucose Management

Abstract Aims: This study was to evaluate the effects of the home quarantine on pregnancy outcomes of gestational diabetes mellitus (GDM) patients during the COVID-19 outbreak.Methods: Thecomplete electronic medical records of GDM patients with home quarantine history were collected and classified into the home quarantine group from 24 February 2020 to 24 November 2020. The same period of GDM patients without home quarantine historywas included in the control group from 2018 and 2019.Results: A total of 1358 GDM patients were included in the analysis, including 484 in 2018, 468 in 2019, and 406 in 2020. GDM patients with home quarantine in 2020 had higher glycemic levels and worse pregnancy outcomes than 2018 and 2019, including higher cesarean section rate,lower Apgar scores, and higher incidence of macrosomia and nuchal cord. More importantly, the second trimester of home quarantine had brought a broader impactto pregnant women and fetuses.Conclusion: Home quarantine has aggravated the condition of GDM pregnant women and brought more adverse pregnancy outcomes during the COVID-19 outbreak. Therefore, we suggested that governments and hospitals should strengthen lifestyle guidance, glucose management, and antenatal care for GDM patients with home quarantine during public health emergencies.

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