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

Author(s):  
Bharati Das ◽  
Puspanjali Khuntia

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.

2018 ◽  
Vol 19 (2) ◽  
pp. 98
Author(s):  
Mohammad Saifur Rahman ◽  
Sadia Sultana ◽  
Ayesha Nazneen

<p><strong>Objectives:  </strong>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.</p><p><strong>Patients and Methods: </strong>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 FT<sub>3</sub>, FT<sub>4</sub>, 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 FT<sub>3</sub>, FT<sub>4</sub>, 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.</p><p><strong>Results:  </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p>Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016</p>


2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Eda Demir Onal ◽  
Muhammed Sacikara ◽  
Fatma Saglam ◽  
Reyhan Ersoy ◽  
Bekir Cakir

Cushing’s syndrome (CS) may alter the performance of the hypothalamic-hypophyseal-thyroid axis. We searched for a relationship between hypercortisolism and primary thyroid disorders. The medical records of 40 patients with CS were retrospectively examined. Thyroid ultrasonography (USG), basal thyroid function test results (TFT), and antithyroglobulin and antithyroperoxidase antibodies were analyzed. In 80 control subjects, matched by age and gender with CS patients, thyroid USG, TFTs, and autoantibody panel were obtained. Among the CS patients, 17 had nodular goiter, versus 24 controls (42.5% versus 30%,P>0.05). Among the twenty-five patients with an available TFT and autoantibody panel—before and after surgical curative treatment—autoantibody positivity was detected in 2 (8%) patients before and 3 (12%) after surgery (P=0.48). Regarding TFT results, 1 (2.5%) patient had subclinical hyperthyroidism and 1 (2.5%) had subclinical hypothyroidism, whereas 1 (2.5%) control had hyperthyroidism. In total, 21 (52.5%) patients and 32 (40%) controls had≥1 of the features of thyroid disorder, including goiter, positive thyroid autoantibody, and thyroid function abnormality; the difference was not significant (P>0.05). The prevalence of primary thyroid disorders is not significantly increased in patients with CS.


Author(s):  
Dr. Yasser Al-Ankoodi

Thyroid function test (TFT) is one of the frequently asked investigations. There is continuous increase and demand for this test. The reasons for increased number of thyroid testing include the wide list of clinical presentation of thyroid disorders with variable signs and symptoms.  The thyroid gland itself can be affected with different ranges of disorders including auto-antibodies, congenital, genetics and cancers (1,2). In addition, the thyroid disorders can mimic or co-exist with other conditions especially in elderly and children.  This climbing number of tests makes a financial burden to the laboratory. It necessitated extra reagents and consumables, extra manpower and some time extra analyzer.


Author(s):  
Sreelatha S. ◽  
Seema Nadagoudar ◽  
Asha Devi L.

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.


2014 ◽  
Vol 3 (1) ◽  
pp. 48-50 ◽  
Author(s):  
TL Upadhyaya ◽  
A KC ◽  
S Paudel

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Nepal and its potential complications. Methods: One Hundred seven pregnant cases from Gandaki Medical college teaching hospital and Diabetes thyroid and Endocrinology care center, two of the tertiary care centers in Pokhara were enrolled in the study from the year 2011 January to 2012 December. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4 andTSH) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Seven patients dropped out from the study. Results: Out of 107 patients 56 patients had TSH below 6 mIU/L,31patients had TSH between 6mIU/L - 10 mIU/L and 13 patients had TSH more than 10 mIU/L. Seven patients dropped out from the study. There was1 miscarriage, 1 still birth from hypothyroid mother and 11 hypothyroid and subclinical hypothyroid mothers had preterm delivery. Conclusion: Prevalence of overt hypothyroidism is around 13% and subclinical hypothyroidism is around 31% in pregnant ladies in western Nepal. Also complications like stillbirth should be prevented by detecting and treating hypothyroidism early. So we recommend all patients with pregnancy to perform thyroid function test at the start of pregnancy. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 48-50 DOI: http://dx.doi.org/10.3126/njms.v3i1.10358


Author(s):  
Deepika Sharma ◽  
Pratibha V. Dixit ◽  
Yogita Gavit

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.


2012 ◽  
Vol 9 (2) ◽  
pp. 7-10
Author(s):  
K Subba ◽  
D Karn ◽  
R Khatri

BackgroundVitiligo is a common pigmentary disorder of the skin, affecting individuals globally. Not only is this ailment psychologically incapacitating, it also has a high incidence of autoimmunity, signifying that its manifestations may be the portrayal of dysfunction of immune system. ObjectiveThe aim of this study is to find out the situations of abnormal thyroid function test (TFT) in vitiligo patients. MethodsA prospective cross sectional study was conducted at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to January 2011 with the objective to assess the thyroid function tests in vitiligo patients. ResultsTotal 66 vitiligo patients with male 30 (45%) and female 36 (55%). Total 26 (39.39%) vitiligo patients have been found to have abnormal thyroid function test. Among them 10 had abnormal T3, seven had abnormal T4 and 12 had abnormal TSH level. Thyroid function test were normal in other vitiligo patients. Total seven vitiligo had high level of T3 than normal value, four male and three female. Two had higher level of T4 above 2.0 ng/dl and all were male, while five had abnormally low level of T4 with three male and two female. There were seven vitiligo patient with increased T3 level and three with decreased T3 level, among them six were males and four were females, the age group was ranged from seven to 68 years old. The T4 level were found abnormal in seven vitiligo patients among which five were males and two were females with the age group ranging from 7 to 51 years. ConclusionsThere has been significant association of thyroid disorder in the patient with vitiligo. Therefore, patient with vitiligo need to undergo thyroid function test to rule out the thyroid disorder and prevent from long-term complications.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6279Kathmandu Univ Med J 2011;9(2):7-10 


2017 ◽  
Vol 25 (1) ◽  
pp. 19-26
Author(s):  
Neeraj Aggarwal ◽  
Sirshak Dutta ◽  
Tanaya Panja ◽  
Mainak Dutta ◽  
Sanjoy Kumar Ghosh ◽  
...  

Introduction Hypothyroidism is a significant but an under-appreciated complication of hemithyroidectomy. The focus of this study was to assess the incidence of hypothyroidism occurring after hemithyroidectomy, identify the risk factors and to suggest a possible follow-up guideline for diagnosis. Materials and Methods An institution based preliminary study was conducted in the Department of Otorhinolaryngology, in a tertiary care hospital, from August 2014 to December 2015 on 25 patients. The patients were regularly followed up in 1st month, 3rd month, 6thmonth, 9th month and 1 year period with the thyroid function test. Results Incidence of hypothyroidism occurring after hemithyroidectomy including transient and permanent cases is 32%. Increased age of presentation, longer duration of thyroid swelling, pre-operative serum TSH level >2.5 mIU/ml, lymphocytic infiltration in histopathology and right sided hemithyroidectomy were found to be the possible risk factors. Conclusion It is indicated from this preliminary report that there should be a serial thyroid function monitoring in every post-operative hemithyroidectomy patient, and special attention should be given to the risk group


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