scholarly journals A study of effects of hypothyroidism on antenatal patients

Author(s):  
Payal Saha ◽  
Tushar Palve ◽  
Pooja R.

Background: After diabetes mellitus, thyroid disorders are the most common endocrine disorders in pregnancy. The most common thyroid gland dysfunction in pregnancy is hypothyroidism with estimated prevalence of 1.5-4.4% of pregnant women. Effects of hypothyroidism in pregnancy include anemia, pre-eclampsia, prematurity, IUGR, low birth weight, mental retardation in neonate. The objective of this study is to find the association of hypothyroidism and its adverse outcomes on mother and the fetus that is listed above.Methods: A study was conducted over a period of 6 months over 50 antenatal patients with hypothyroidism from Jan 2021 to August 2021 in the department of obstetrics and gynecology, Cama and Albless hospital, Mumbai with inclusion, exclusion criteria. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion and fetal outcomes were the main study variables.Results: In this study, majority of hypothyroidism belonged to the age group of 26-30 years (54%). A high prevalence was found in G2 (26%) and antenatal hypothyroidism with past h/0 abortions were found in 26% patients. Low birth weight is found in 32% cases of hypothyroidism, NICU admissions seen in 32% cases of hypothyroidism, 22% cases were found to have anemia.Conclusions: Hypothyroidism is a common health problem in antenatal patients. We concluded that hypothyroidism is more commonly seen to be associated with low birth weight, anemia, pre-eclampsia, NICU admission in neonate. Early ANC registration and regular ANC checkups help in early recognition and initiating early treatment, thus improving fetomaternal outcome. 

2021 ◽  
Vol 15 (10) ◽  
pp. 3423-3425
Author(s):  
Amna Najam ◽  
Samreen Fakeer Muhammad ◽  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Maria Anwar

Objective: The aim of this study is to compare the fetal and maternal outcomes in between asymptomatic and symptomatic COVID positive pregnant women. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Gynae and Obs department of Sandeman Provincial Hospital, Quetta for duration of six months from November 2020 to April 2021. Methods: One hundred and ten pregnant women with ages 18-45 years had corona virus disease were presented. Informed written consent was taken from all patients for detailed demographics. COVID -19 was diagnosed by PCR. 55 patients had symptoms of coronavirus were included in group A and 55 patients did not show symptoms were included in group B. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Maternal adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. SPSS 20.0 version was used to analyze all data. Results: Mean age of the patients in group A was 28.47±3.18 years with mean BMI 24.03±5.24 Kg/m2 and in group B mean age was 27.99±4.17 years with mean BMI 24.44±6.41 Kg/m2. Maternal outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor,) in symptomatic group were significantly higher than that of asymptomatic group. Fetal outcomes, perinatal mortality in group A 9 (16.4%) and in group B was 5 (9.1%), low birth weight in group A was among 21 (38.2%) and in group B was 10 (18.2%), low apgar score in group A was 11 (20%) and in group B was 8 (14.4%), 15 (27.3%) in group A went to NICU admission and 3 (5.5%) patient in group II admitted to NICU. Conclusion: In this study we concluded that adverse outcomes among symptomatic COVID pregnant women were higher than that of asymptomatic coronavirus pregnant women in terms maternal and perinatal outcomes. Keywords: Pregnant women, Coronavirus, Symptomatic, Asymptomatic, Adverse Outcomes


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Eryk Hakman ◽  
Sasha Mikhael

Background. Catastrophic APS (CAPS) is a rare but life-threatening form of APS defined as multiorgan thrombosis affecting a minimum of three organs with confirmation by histopathology of small vessel occlusions in at least one organ or tissue. The development of CAPS in pregnancy poses many diagnostic challenges as a result of its broad range of clinical presentations and its overlap with other obstetric complications and microangiopathic diseases. Because of the high associated mortality rate, prompt recognition and treatment are paramount. Case. A twenty-five-year-old G3P0111 with a history of multiple thromboembolisms presented at 21 weeks and 3 days of gestation with complaints of right upper quadrant pain, visual disturbances, headache, and syncopal episodes. Laboratory evaluation demonstrated microangiopathic disease with hemolysis (confirmed on peripheral smear), elevated liver enzymes, and abnormal 24-hour urine protein with vital signs within the normal range. Presence of significantly elevated antiphospholipid antibodies was noted, facilitating the diagnosis of probable CAPS. Proper workup was achieved based on clinical suspicion, allowing immediate and appropriate management. Conclusion. CAPS is a life-threatening condition rarely seen in pregnancy making early recognition difficult. A low threshold to initiate urgent and aggressive treatment should be maintained to minimize the risk of adverse outcomes.


Author(s):  
Sasmita Das ◽  
Tapan Pattanaik ◽  
Manisha Sahu

Background: The aim of this study is to assess whether third trimester haemoglobin level can be used as a predictor of feto-maternal adverse outcomes in pregnancies complicated with PIH.Methods: This is an observational study in the Obstetrics and Gynaecology Department of IMS and SUM hospital, SOA university from July 2015 to December 2017. Institutional ethical committee permission obtained. All singleton pregnancies delivered during this period with PIH were included in the study. PIH and eclampsia was diagnosed as per ISSHP criteria. All chronic hypertension cases excluded. All were evaluated with haemoglobin level. They were divided into 3 groups depending upon haemoglobin level; low (<11gm%), normal (11-13gm%) and high haemoglobin group (> 13gm%) considering the WHO standard. Maternal complications observed were incidence of eclampsia, abruptio placentae, HELLP syndrome, PPH, neurological complications, ICU admissions and death. Fetal outcomes studied were NICU admission, stillbirth, incidence of prematurity and low birth weight. All these parameters were compared among 3 groups. Statistical analysis was done with SPSS 20 software using Yate’s corrected chi square test.Results: Incidence of eclampsia was significantly greater with both high (p<0.001) and low (p=0.0085) haemoglobin level than normal haemoglobin level. Maternal complications and adverse perinatal outcomes (stillbirth, low birth weight, prematurity, NICU admission) are significantly greater with high haemoglobin level than cases with normal haemoglobin level. There is no significant difference in maternal and perinatal complications between low and normal haemoglobin group.Conclusions: High haemoglobin level >13gm% in third trimester is associated with worst feto-maternal outcome whereas normal haemoglobin level (11-13gm%) is associated with least feto-maternal complications.


2019 ◽  
Vol 15 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Harpriya Kaur ◽  
Delf Schmidt-Grimminger ◽  
Baojiang Chen ◽  
K.M. Monirul Islam ◽  
Steven W. Remmenga ◽  
...  

Background: Pregnancy may increase the risk of Human Papillomavirus (HPV) infection because of pregnancy induced immune suppression. The objective of this study was to use a large population-based dataset to estimate the prevalence of HPV infection and its association with adverse outcomes among pregnant women. Methods: We analyzed Pregnancy Risk Monitoring System data from 2004-2011 (N=26,085) to estimate the self-reported HPV infection. Survey logistic procedures were used to examine the relationship between HPV infection and adverse perinatal outcomes. Results: Approximately 1.4% of women were estimated to have HPV infection during their pregnancy. The prevalence of adverse outcomes in this sample was preterm birth (8.4%), preeclampsia (7.5%), low birth weight (6.3%) and premature rupture of membranes (2.8%). Compared to women without HPV infection, HPV infection positive women were much more likely to have had other infections such as chlamydia (9.23% vs. 2.12%, p-value <.0001), Group B Strep (21.7% vs. 10.04%, p-value <.0001), and herpes (7.17% vs. 1.07%, p-value <.0001). After adjusting for other risk factors including other infections, HPV infection was significantly associated with low birth weight (OR: 1.94, 95% CI: 1.14-3.30). Conclusion: The study indicated a potential association between HPV infection and low birth weight. Because pregnant women with HPV infection are at higher risk of other infections, future research may focus on the roles of co-infection in the development of adverse perinatal effects.


Author(s):  
K. Famra ◽  
P. Barta ◽  
A. Aggarwal ◽  
B.D. Banerjee

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.


Author(s):  
Heidi K. Al-Wassia ◽  
Shahd K. Baarimah ◽  
Asmaa H. Mohammedsaleh ◽  
Manal O. Alsulami ◽  
Ragad S. Abbas ◽  
...  

Objective Low birth weight (LBW) infants (<2,500 g) continued to be a global health problem because of the associated short- and long-term adverse outcomes. The study aimed to determine the prevalence, risk factors, and short-term outcomes of term LBW infants Study Design A prospective and case–control study. All infants born consecutively from September 1, 2018 to August 31, 2019 were included. Cases, term LBW infants, were 1:1 matched to controls, appropriate for gestational age (AGA) term infants. Major congenital or chromosomal anomalies and multiple pregnancies were excluded. Results The prevalence of term LBW in the studied period was 4.8%. Mothers of term LBW infants had significantly lower body mass index (p = 0.05), gained less weight (p = 0.01), had a history of previous LBW (p = 0.01), and lower monthly income (p = 0.04) compared with mothers of term AGA infants even after adjustment for confounders. A nonsignificant higher number of term LBW infants needed NICU admission, while their need for phototherapy was deemed significant. Conclusion We identified nutritional and socioeconomic maternal factors that are significantly associated with LBW infants and should be targeted during antenatal visits to improve neonatal outcomes. Key Points


2021 ◽  
pp. 40-41
Author(s):  
Vasudha Rani ◽  
Punam Kumari

Pregnancy is a nature's gift of humanity for procreation and continuation of its race. This gift is however fraught with several complications and has potential threat to the mother and the foetus. When pregnancy is compounded by endocrine disorders such as hypothyroidism, the potential for maternal and foetal adverse outcomes can be immense. While a lot of attention has been focused on the adverse foetal outcomes consequent to hypothyroidism, attention is also being gradually directed towards the adverse maternal outcomes of this disorder. Role of antibody positivity in inuencing outcomes in a euthyroid woman, also needs further clarication. Prompt diagnosis and treatment of hypothyroidism in pregnancy is very essential. Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal. Since women with hypothyroidism during pregnancy, especially of the autoimmune variety might have a are up of the disorder post-partum, or might continue to require thyroxine replacement post-partum, adequate follow-up is mandatory. While targeted case nding is generally practised, recent evidence seems to indicate that universal screening might be a better option. In conclusion, routine screening, early conrmation of diagnosis and prompt treatment allied with regular post-partum follow up, is required to ensure favourable maternal and foetal outcomes.


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