Maternal and perinatal outcome in hypothyroidism in pregnancy: a prospective observational study

Background: This study was conducted to analyse the antenatal complications, perinatal outcome and to be advocate routine screening for thyroid disorders in pregnancy. This study was prospective and observational study with 50 cases which was newly diagnosed when suspected as pregnancy with thyroid disorders. The commonest thyroid disorder found in pregnancy is hypothyroidism and it adversely affects the maternal and fetal health in the form of infertility, early pregnancy loss, PIH, anaemia, IUGR, PROM, preterm labor, neonatal and maternal morbidity and mortality. If thyroid disorders are appropriately detected and treated either before or in early pregnancy, the adverse maternal and fetal outcome can be prevented.Methods: The present study was conducted in a tertiary care centre Mumbai from June 2015 to October 2016. All pregnant females who are newly diagnosed as hypothyroid, attending the ANC clinic were enrolled in the study.Results: In the present study, most common obstetric complication observed was preeclampsia and most common fetal complication was preterm delivery.Conclusions: In view of the high prevalence of thyroid dysfunctions in Indian pregnant woman and its association with different adverse pregnancy related complications we recommend routine screening for thyroid dysfunctions in pregnancy.

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Thyroid dysfunction among Indian pregnant women and its effect on the maternal and fetal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210528 ◽

2021 ◽

Vol 10 (3) ◽

pp. 893

Author(s):

Aditi Jain ◽

Raksha M. ◽

Kanakalatha D. Nakum

Keyword(s):

Early Pregnancy ◽

Tertiary Care ◽

First Trimester ◽

Antenatal Clinic ◽

Fetal Outcome ◽

Overt Hypothyroidism ◽

Thyroid Disorders ◽

Care Hospital ◽

Thyroid Disorder

Background: Screening of thyroid disorders in antenatal women during first trimester, to recommend management of thyroid disorder during pregnancy and to know the maternal and fetal outcome of such pregnancy.Methods: This is a prospective study for the incidence of thyroid disorder in early pregnancy and the outcome of such pregnancy. 100 cases were randomly selected from the antenatal clinic at a tertiary care hospital in India and after fulfilling the inclusion criteria they were subjected to screening for thyroid disorder till 13 weeks of pregnancy. TSH is often considered the “gold standard” for assessing thyroid function. If the participant had normal value then she was not subjected to follow up, but if abnormal, then follow up was done after 4-8 weeks, thyroid profile was repeated and if values were altered, they were medically managed and closely monitored. The obstetric and perinatal outcome of the pregnancy was noted.Results: In this screening study to detect and manage thyroid disorder, 100 antenatal women were selected randomly, from which 49 women where primigravidae and 51 women were multi-gravidae, 17 of them were of <20years, 54 were between 21 to 25 years. There was 5 percent incidence of thyroid disorder in the study group. There were 3 cases of hyperthyroidism and 2 cases of overt hypothyroidism which had poor fetal and maternal outcome on follow up.Conclusions: Our study shows that the evaluation of thyroid disorders in early pregnancy and timely intervention will lead to a decrease in the complications thereby improving the maternal and fetal outcome.

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Thyroid disorder in pregnancy and postpartum with neonatal outcome a study in tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191503 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1795

Author(s):

Bharati Das ◽

Puspanjali Khuntia

Keyword(s):

Thyroid Function ◽

Post Partum ◽

Tertiary Care ◽

Thyroid Function Test ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

New Born ◽

Pregnancy And Postpartum ◽

Function Test ◽

In Pregnancy

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences. Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.

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Assessment of Thyroid Function in Early Pregnancy

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i2.35864 ◽

2018 ◽

Vol 19 (2) ◽

pp. 98

Author(s):

Mohammad Saifur Rahman ◽

Sadia Sultana ◽

Ayesha Nazneen

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Early Pregnancy ◽

Correct Diagnosis ◽

First Trimester ◽

Military Hospital ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

Cross Sectional ◽

In Pregnancy

Objectives: Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians. The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.Patients and Methods: A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT3, FT4, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT3, FT4, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.Results: Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.Conclusion: Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016

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Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190263 ◽

2019 ◽

Vol 8 (2) ◽

pp. 425

Author(s):

Shruti Uniyal ◽

Ritika Agarwal ◽

Nupur Nandi ◽

Pulkit Jain

Keyword(s):

Observational Study ◽

Low Socioeconomic Status ◽

Treatment Options ◽

Tertiary Care ◽

Liver Function Tests ◽

Skin Lesions ◽

Personal Hygiene ◽

Tertiary Care Centre ◽

Palmar Erythema ◽

In Pregnancy

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.

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Maternal Near Miss Events in Tertiary Care Hospital: A Retrospective Observational Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47901.14772 ◽

2021 ◽

Author(s):

Sonali J Ingole ◽

Shilpa N Chaudhary

Keyword(s):

Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Severe Anaemia ◽

Near Miss ◽

Maternal Near Miss ◽

Care Hospital ◽

Hypertensive Disorders ◽

Obstetric Haemorrhage ◽

In Pregnancy

Introduction: Over the years, continuous efforts have been made for improving reproductive health status of women. In India, Ministry of Health and Family Welfare (MoHFW) has set Maternal Near Miss (MNM) review operational guidelines. Aim: Analysis of the incidence and causes of MNM cases in tertiary care hospital. Materials and Methods: This retrospective observational study was undertaken at a tertiary care hospital from January 2010 to September 2018. MNM cases were identified according to the criteria given by MoHFW, MNM review operational guidelines. Following parameters (variables) were noted viz., age, parity, obstetric haemorrhage, severe anaemia, sepsis, therapeutic interventions, etc., and analysed. Quantitative data was analysed by calculating means, ratios and proportions, using SPSS software (Version 21.0). Results: There were total 36,366 deliveries during the study period. A total of 315 Maternal Near Miss cases were noted. Hypertensive disorders n=133 (42.2%) in pregnancy was the leading cause of MNM events at the hospital. This was followed by obstetric haemorrhage n =97 (30.79 %), and severe anaemia constituting n=36 (11.42%), and Sepsis n=30 (9.52%). Mortality index was highest in the sepsis group n=5 (14.28%) followed by severe anaemia n=3 (7.69%). Conclusion: Hypertensive disorders were most common cause of near miss cases followed by obstetric haemorrhage. Sepsis was commonest cause of maternal mortality. Early identification of hypertensive disorders in pregnancy, obstetric haemorrhage, severe anaemia and sepsis; and prompt treatment of these causes may help in reducing near miss and maternal mortality.

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Prevalence of thyroid disorders among patients attending the antenatal clinic at tertiary care centre, Parel, Mumbai, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170961 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1235

Author(s):

Jaya Kundan Gedam ◽

Disha A. Rajput

Keyword(s):

Tertiary Care ◽

Antenatal Clinic ◽

Overt Hypothyroidism ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

Tertiary Care Centre ◽

Indian Women ◽

Thyroid Screening ◽

A Prospective Study ◽

Overt Hyperthyroidism

Background: Pregnancy is associated with major changes in the physiology of the thyroid gland. Undiagnosed thyroid disorders can adversely affect fetal and maternal outcome. This study was done to study the prevalence of thyroid disorder among antenatal women.Methods: This was a prospective study done in the antenatal clinic in the Department of Obstetrics and Gynaecology, ESI PGIMSRMGM Hospital, Parel, Mumbai, India.Results: In present study, fifty out of three hundred and fifty pregnant women screened had thyroid disorder. The prevalence of thyroid disorder in this study was 14.2%. The prevalence of subclinical hypothyroidism was 7.7% (n= 27), overt hypothyroidism was 4% (n=14), subclinical hyperthyroidism was 1.7% (n=6) and overt hyperthyroidism was 0.8% (n=3).Conclusions: Thyroid disorders in pregnancy are associated with adverse fetomaternal outcome. Its prevalence is high in Indian women. Thus thyroid screening should be included in the routine antenatal investigations.

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