scholarly journals A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome in a tertiary health centre located in central India

2020 ◽  
Vol 9 (8) ◽  
pp. 3393
Author(s):  
Manjari G. Jain ◽  
Neeraj K. Jain ◽  
Mita Mazumdar
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
Health Centre ◽  
First Trimester ◽  
Fetal Outcome ◽  
Prospective Clinical Trial ◽  
Research Centre ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
Medical College

Background: A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome was done in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective study was carried out in antenatal women in their first trimester attending antenatal OPD in RKDF Medical College and Research Centre, Bhopal, Madhya Pradesh to know the prevalence of thyroid disorder and its association with pregnancy outcome.Results: In this study prevalence of thyroid disorder was 12.4%, subclinical hypothyroidism 7.2%, overt hypothyroidism 3.4%, subclinical hyperthyroidism 1.4%, overt hyperthyroidism 0.4%. Thyroid disorder is responsible for several obstetrical and fetal complication like pre-eclampsia, preterm delivery, abortion, IUGR and low birth weight.Conclusions: Thyroid disorder associated with poor obstetrical outcome and fetal complication. so timely diagnosis and treatment is required. Universal screening should be preferred over high-risk screening because of high prevalence of the disease in India.

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

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.

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.

scholarly journals Study of thyroid hormones in pregnancy

2020 ◽  
Vol 9 (10) ◽  
pp. 4086
Author(s):  
Madhu Juneja ◽  
Salil Barsode ◽  
Tushar Panchanadikar
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Tertiary Care ◽  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorder ◽  
Medical College ◽  
Systemic Examination ◽  
A Prospective Study

Background: Thyroid disorder is often overlooked in pregnant women this is because of nonspecific symptoms and hyper metabolic state of normal pregnancy. To evaluate the thyroid function in pregnant women in all the three trimesters and to study their impact on pregnancy outcome.Methods: A prospective study in 200 randomly selected antenatal cases was carried out during a period of two years in a tertiary care medical college in Western Maharashtra. A detailed general and systemic examination was carried out and Thyroid stimulating hormone (TSH) was done in all cases. Any case with an abnormal TSH level was further tested for T3 T4 levels.Results: The mean TSH level was 1.6 µIU/l which was less than the standard cut off of 2.5 µIU/l. 61% had decreasing level of TSH with advanced gestation. An abnormal thyroid function was seen in 8.5% cases.Conclusions: Standardization of TSH, T3, T4 is still a concern as it varies significantly in different studies. Estimation of TSH with T3 T4 could not be correlated during pregnancy with advancing gestational age. The real impact of hypo/hyperthyroidism on fetal outcome could not be statistically established.

scholarly journals Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up

2018 ◽  
Vol 7 (4) ◽  
pp. 1586 ◽  
Author(s):  
Nancy S. Pillai ◽  
Jemela Bennet
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Intellectual Development ◽  
Thyroid Dysfunction ◽  
First Trimester ◽  
Reproductive Age ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
Thyroid Disorder ◽  
In Pregnancy

Background: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. During early pregnancy the foetus is totally dependent on maternal thyroid hormone supply. Thyroid hormone is critical for foetal brain and intellectual development and some preventable conditions like abruption, pre-eclampsia etc. which produce morbidity and pose special risk for pregnancy and the developing foetus.Methods: All subjects enrolled in the study as per the inclusion criteria will be subjected to a detailed history and clinical examination using a predesigned proforma. A serum TSH value will be sent in 1st trimester between 6-10 weeks period of gestation for all pregnant women.Results: The prevalence of thyroid dysfunction in pregnancy was 10.8% with hypothyroidism being 9.2%, out of which 8.5% were cases of subclinical hypothyroidism and 0.7% were cases of overt hypothyroidism. On assessing the risk factors for developing thyroid dysfunction in pregnancy, increases in incidence were seen with maternal age and increasing BMI, both of which were statistically significant.Conclusions: This study showed an increased prevalence of hypothyroidism in pregnancy recommending a need for universal screening for all pregnant women in the first trimester itself. This study aims at validating the efficacy of the above-mentioned screening.

scholarly journals Optimal management of diabetic pregnancies and its current practice: a one-year study in a tertiary care center

2020 ◽  
Vol 9 (11) ◽  
pp. 4654
Author(s):  
Pooja Kiran ◽  
Kamal P. Patil
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Diabetes ◽  
First Trimester ◽  
Fetal Outcome ◽  
Adverse Outcomes ◽  
Research Centre ◽  
In Pregnancy

Background: Diabetes is one of the largest global health emergencies of 21st century and Gestational diabetes mellitus (GDM) is one of the most crucial illnesses complicating women of child-bearing age. The objectives of this study is to determine the maternal and fetal outcome of pregnancies complicated by maternal diabetes either GDM or pre-existing diabetes.Methods: An analysis of pregnant women was done retrospectively at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. 171 cases were diagnosed with diabetes mellitus in pregnancy. 162 cases developed GDM and 9 had pre-existing diabetes. Pregnant women who were found to be diabetic pre conceptionally or in the first trimester were classified as pre-existing diabetes. All pregnant women diagnosed with diabetes mellitus were studied and relevant maternal and fetal outcomes and complications were assessed.Results: There were171 diabetic women in this retrospective study out of which 94.7% had GDM and 5.26% had pre-existing diabetes. Rate of pre-eclampsia was 24.56%, preterm delivery was 17.54% and polyhydramnios was 15.20%. Rate of caesarean section were 57.30% and vaginal delivery was 45.06%. In fetal and neonatal complications, the rate of fetal macrosomia was 11.1%, hyperbilirubinemia 15.78%, respiratory distress syndrome 9.94%.Conclusions: Diabetes in pregnancy is associated with increased risks to the maternal and fetal complications. The aim of this study is to lay emphasis upon early detection, screening and timely management that will reduce the adverse outcomes in both mother and fetus. predicted.

scholarly journals Anemia among Pregnant Women at Nepalgunj Medical College

2022 ◽  
Vol 19 (1) ◽  
pp. 81-83
Author(s):  
Durga BC
Keyword(s):  
Pregnant Women ◽  
Megaloblastic Anemia ◽  
First Trimester ◽  
Fetal Outcome ◽  
Hemoglobin Level ◽  
World Health ◽  
Deficiency Anemia ◽  
Medical College ◽  
Anemia During Pregnancy ◽  
Prevalence Of Anemia

Introduction: Anemia in pregnancy is major health issue of developing countries responsible for adverse maternal and fetal outcome. According to World health organization pregnant women with hemoglobin level less than 11 gm/dl in first trimester and less than 10.5gm/dl in second and third trimester are considered to be anemic. Iron deficiency anemia is common during pregnancy followed by megaloblastic anemia. Aims: To find out the prevalence of anemia during pregnancy. To correlate the maternal and fetal complications associated with anemia during pregnancy. Methods: This is a prospective hospital based study done at department of obstetrics and gynecology Nepalgunj Medical College from July 2020 to January 2021. All pregnant women with hemoglobin level <11 gm/dl were enrolled in the study. Data were collected from antenatal clinic and biochemistry laboratory. Results: In this study maximum participants were of age group 20-25 consisting of 38.5%. Anemia was more common in multiparous i.e. 60% as compared to primipara i.e. 40%. In this study maximum participant had vaginal delivery (57%) followed by LSCS (29%) then instrumental delivery (14%). These ladies had complications like postpartum hemorrhage (27.7%), preterm labor (16.9%), pregnancy induced hypertension (9.2%). similarly 10.8% had sepsis and 20% had no complications. About 23.1% babies delivered by anemic ladies required neonatal intensive care.  Intrauterine growth restriction was seen in 12.3%, preterm birth in 10.3% and 53.8% babies had no complications. Conclusion: The prevalence of anemia during pregnancy is high leading to adverse maternal and fetal outcome.

scholarly journals Screening of Thyroid Disorder among Pregnant Ladies in a Tertiary Hospital of Nepal

2019 ◽  
Vol 21 (3) ◽  
pp. 235-239
Author(s):  
Biloni Shrestha ◽  
P. Adhikari
Keyword(s):  
College Teaching ◽  
First Trimester ◽  
Tertiary Hospital ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorder ◽  
Medical College ◽  
Physiological Changes In Pregnancy ◽  
Antithyroid Peroxidase Antibody ◽  
In Pregnancy

Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many physiological changes in pregnancy lead to hypothyroidism in pregnancy. Hypothyroid in pregnancy is associated with many adverse maternal and fetal outcomes. Objective of this study was to find the prevalence of TD in pregnancy in Nepal Medical College Teaching Hospital (NMCTH), Antithyroid Peroxidase Antibody (TPO-Ab) positive cases with hypothyroidism and to evaluate maternal fetal outcome in hypothyroid pregnancies. This was a prospective hospital based observational study. The study was done in Department of Obstetrics and Gynecology, NMCTH from August 2018 to July 2019. Among 420 pregnant ladies 71.0% were euthyroid, 25.7% were hypothyroid (25.2%of subclinical and 0.5% overt), 3.3% were hyperthyroid (0.7% of overt) and 6.4% were TPO-Abpositive with hypothyroidism. Inspite of treatment, Gestational hypertention, Pre-eclampsea and LSCS is significantly high in hypothyroid pregnancy than euthyroid pregnancy. High prevalence of hypothyroidism in this study necessitates universal screening of TD at first trimester of pregnancy.

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 dysfunction and its effects on fetomaternal outcome in pregnant women of Eastern Uttar Pradesh, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4379
Author(s):  
Ankita Kumari ◽  
Reena Srivastav ◽  
Shaila Mitra
Keyword(s):  
Thyroid Dysfunction ◽  
Uttar Pradesh ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Medical College ◽  
Thyroid Screening ◽  
Fetal Complications ◽  
Adverse Pregnancy ◽  
Eastern Uttar Pradesh

Background: The aim of the study is to determine the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Eastern Uttar Pradesh.Methods: This was a prospective observational study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur. Total 720 antenatal women, ≤20 weeks of gestation were recruited for the study. In all patients’ routine obstetrical investigations and thyroid function tests were done. All patients were followed up to delivery. Maternal and perinatal outcome were ascertained.Results: Prevalence of thyroid dysfunction among pregnant was found to be 21.1% and subclinical hypothyroidism (15.9%) was the commonest thyroid disorder. Most common complication observed in subclinical and overt hypothyroidism was preeclampsia (9.56 % versus 20%) followed by preterm labour (7.82% versus 10%). Major fetal complications in hypothyroid mothers included intrauterine growth restriction, low birth weight and stillbirth.Conclusions: Prevalence of hypothyroidism was found to be high in our study and was associated with adverse pregnancy outcomes; hence, thyroid screening should be included in routine antenatal investigations.

scholarly journals Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial

2020 ◽  
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Paula G Cocate ◽  
Camila Benaim ◽  
Maria Claudia da Veiga Carvalho ◽  
Michael M Schlüssel ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
Low Income ◽  
Quantitative Data ◽  
Health Centre ◽  
Feasibility Trial ◽  
Random Allocation ◽  
Eligibility Criteria ◽  
Related Factors ◽  
Phone Calls

Abstract Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aim of this study is to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy (PT) and describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study. Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2x2 factorial feasibility clinical trial were used. 18 women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions and data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (>20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, unresponsive to phone calls, and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthy and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation cost) could hinder participation in the study. Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related socio-demographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.

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