scholarly journals Study on thyroid function test in pregnancy in a tertiary care hospital

2021 ◽  
pp. 20-25
Author(s):  
Ajit Kumar Nayak ◽  
Manorama Swain ◽  
Sujata Misra ◽  
Manju Kumari Jain
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
Free T4

Thyroid disorder is a very common endocrine problem encountered by pregnant women. Maternal thyroid dysfunction is associated with adverse outcome both in mother and fetus. The aim of the study: to find out the prevalence of various thyroid disorders in pregnant women attending antenatal clinic. Materials and methods. This prospective cross-sectional study was carried out in the Department of Obstetrics and Gynecology, F.M. Medical College & Hospital, Balasore, Odisha from June 2020 to May 2021. 220 women with uncomplicated singleton pregnancy were included. Serum Thyroid-stimulating hormone (TSH), free T4 (FT4) and free T3 (FT3) were estimated by using electro-chemiluminescence immunoassay technique. Results. Out of 220 pregnant women screened for thyroid dysfunction, 68 were found to have thyroid disorders. 27.3 % of pregnant women had subclinical hypothyroidism, 1.4 % had overt hypothyroidism, 1.8 % had subclinical hyperthyroidism and 0.5 % had overt hyperthyroidism. Prevalence of subclinical hypothyroidism was 6.36 % when the upper reference limit of TSH level taken as 4 mIU/L. Prevalence of thyroid disorder among pregnant women in the age groups 18–25 years, 26–30 years and 31–40 years were 28.9 %, 32.1 % and 38.9 % respectively. There were 35.5 %, 28 % and 26 % pregnant women with thyroid disorders in the first, second and third trimester respectively. Prevalence of both subclinical and overt hypothyroidism were more in multigravida compared to primigravida. Conclusion. Our study revealed high prevalence of thyroid disorders in pregnant women and maternal subclinical hypothyroidism was the most common pattern.

scholarly journals Prevalence of thyroid disorders among pregnant women at a tertiary care hospital in Rajasthan

2021 ◽  
Vol 10 (3) ◽  
pp. 1111
Author(s):  
Shalini Singh ◽  
Pragya Shree ◽  
Vaibhav Kanti ◽  
Kalpana Kumari ◽  
Rajeev Suchdeva
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
First Trimester ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Second Trimester ◽  
Maternal Weight

Background: Hormonal changes and metabolic demands during pregnancy result in profound alterations in the biochemical parameters of thyroid function. Screening for thyroid disorders and initiation of its management at the earliest stage during first trimester is essential as maternal thyroid failure during the first half of pregnancy has been associated with several pregnancy complications and intellectual impairment in offspring. Aim was to evaluate the prevalence of thyroid dysfunction during the first and second trimester of pregnancy among women of Rajasthan state in India.Methods: The study comprised a cohort of 313 consecutive pregnant women in the first and second trimester that attended the OPD and were admitted as pregnant women in Obstetrics and Gynecology Department of the NIMS Medical College and Hospital, Jaipur, Rajasthan. Thyroid stimulating hormone (TSH) levels and free T4 (fT4) were estimated. The subjects were grouped into six groups based on the value of serum TSH and fT4.Results: Out of 313 antenatal women enrolled in the study, 213 (68%) attended antenatal clinic in first trimester of pregnancy and 100 (32%) women in their second trimester. The prevalence of thyroid dysfunction was 15.97% (overt hypothyroidism 1.28%, subclinical hypothyroidism 4.79%, isolated hypothyroxinemia 4.47%, overt hyperthyroidism 1.92%, and subclinical hyperthyroidism 3.51%). The women with overt hypo- or hyperthyroidism and subclinical hypothyroidism were older than euthyroid women. Maternal weight was high in pregnant women with overt hypothyroidism (58.22±6.18 kg) and subclinical hypothyroidism (52.04±2.94 kg). Gravid status was high in pregnant women with overt hypothyroidism, subclinical hypothyroidism and isolated hypothyroxinemia, but low in hyperthyroid group. History of miscarriage was high in pregnant women with subclinical hypothyroidism.Conclusions: With this study, it was concluded that there is high prevalence of thyroid dysfunction in pregnancy predominantly in rural population of Rajasthan. Majority among these being subclinical hypothyroidism and hypothyroxinemia.

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 A study of prevalence of primary hypothyroidism in recently diagnosed type 2 diabetes mellitus in a tertiary care hospital

2015 ◽  
Vol 1 (2) ◽  
pp. 105 ◽  
Author(s):  
Sudeb Mukherjee ◽  
Suhana Datta ◽  
Pramathanath Datta ◽  
Apurba K. Mukherjee ◽  
Indira Maisnam
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Primary Hypothyroidism ◽  
Overt Hypothyroidism ◽  
Care Hospital ◽  
Thyroid Disorder

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The association between thyroid dysfunction and DM has long been recognized, although the prevalence of thyroid dysfunction among diabetes population varies in different studies. This study destined to know the prevalence of thyroid dysfunction of recently diagnosed type 2 diabetes mellitus patients.  </p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>Retrospective chart review of 60 patients with type 2 diabetes mellituswas done. Total 60 patients (male 51, female9) fulfillingdiagnostic criteria for diabetes mellitus according to ADA (American Diabetes Association) criteria were analysed by doing Thyroid Function Test (FT4,TSH).</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> 75% of patients have the biochemical features of thyroid dysfunction. Subcategorically in descending order of frequency they are - Subclinical hypothyroidism (33.33%) (defined by no symptoms or clinical fetures of hypothyroidism but biochemically TSH level in the range of above 5 mIU/ml but below 10 mIU/ml with normal FT4 level), 15% of patients each for overt hypothyroidism (either clinical features or Biochemically TSH &gt;10 mIU/ml or FT4 below normal), and subclinical hyperthyroidism (only biochemical low level of TSH &lt;0.34 mIU/ml in this study) and 11.667% patients show the features of clinical hyperthyroidism (clinical or FT4 level well above normal range along with low TSH).</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> Avery high prevalence of thyroid dysfunction in this part of world in contrast to Europe &amp; US suggest routine screening for thyroid disorder in recently diagnosed type 2 diabetes mellitus.</span></p>

scholarly journals A study of thyroid dysfunction among elderly in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 448-453
Author(s):  
Sadhna Sharma ◽  
Biju Govind ◽  
T.S.A. Satyamaharshi ◽  
M.Divya Vani ◽  
, M. Shivshankar
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
The Elderly ◽  
P Value ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Cross Sectional

Introduction and Aim: The prevalence of thyroid disorders all over the world is on the rise. However, the diagnosis is complicated among the elderlies due to factors such as non-specific clinical manifestations and interacting medications. The aim of the study is to estimate the prevalence and type of thyroid dysfunction among the elderly. Materials and Methods: The cross-sectional study was undertaken in the Department of General Medicine of a tertiary care teachinghospital. The study included 100 subjects aged above 60 years, of both genders. Data for clinical examination and biochemical tests such as T3, T4, TSH and lipid profile were collected. Reports of USG/FNAC, performed in cases of thyroid nodule, were also checked.Results:The prevalence of thyroid disorders was 22% of the study population. Overt and subclinical hypothyroidism were observed among 4% and 17% respectively, with 1% having hyperthyroidism. Subclinical hypothyroidism was more common among women. No specific trend was observed with increasing age.TPO antibodies were positive among 73% of the cases. Patients with thyroid dysfunction had higher values of triglycerides, total cholesterol and LDL. The proportion of dyslipidemia was significantly higher among elderly with thyroid dysfunction as compared to people with no thyroid dysfunction (90.90% Vs 24.35%, P value < 0.001). Conclusion: Thyroid dysfunction in the elderly is common. Strong clinical suspicion of thyroid diseases in elderly patients presenting with non-specific symptoms is needed. This would aid in the diagnosis of thyroid disorders among the elderly.

A Study of Clinical Profile of Thyroid Disorders in Children in A Tertiary Care Hospital, Kurnool

2021 ◽  
Vol 8 (2) ◽  
pp. 966-970
Author(s):  
Vedartham Ramesh ◽  
Keyword(s):  
Prevalence Rate ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Age Group ◽  
Free T4 ◽  
Female Ratio ◽  
Free T3

Background: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation, so we want to determine the prevalence of thyroid dysfunction in children at kurnool district. Materials and Methods: A hospital based prospective observational study performed in new born and children below 18 years fulfilling the inclusion criteria visiting the pediatric OPD and IPD in Viswabharathi medical college, Kurnool if they had clinical suspicion of thyroid dysfunction. If suspicion of hypothyroidism, Free T4, Total T4, TSH levels and if suspicion of hyperthyroidism Free T3 and TSH were done. Results: Out of 70 case 3 cases (4.3%) are hyperthyroidism and 67 cases (95.7%) are hypothyroidism in these 3 (4.3%) cases had family history of thyroid disorders, male to female ratio was 1.3:6 and prevalence rate was high in the age group of 10 - 12 years 32.9% (23 cases). 13 (18.6%) cases had thyroid enlargement and 48 (68.57%) cases had anaemia. Treatment was started according to standard guidelines. Conclusion: The higher prevalence rate of thyroid disorders in childhood that to in female children and age group of 10 - 12 years in and around kurnool. Hence, screening of all new-borns and children should be mandatory as early diagnosis and treatment helps in prevention of complications of thyroid disorders. KEY WORDS: Free T3, Free T4, Goiter, Hyperthyroidism, Hypothyroidism, and Thyroid stimulating hormone.

scholarly journals Prevalence of Thyroid Disorder in Pregnant Women Visiting a Tertiary Care Teaching Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 59 (233) ◽  
Author(s):  
Gita Khakurel ◽  
Chandrima Karki ◽  
Sanat Chalise
Keyword(s):  
Pregnant Women ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Sectional Study ◽  
Cross Sectional ◽  
Management Of Complications

Introduction: The function of the thyroid gland is altered during pregnancy. Thyroid disorders during pregnancy are associated with serious maternal and fetal outcomes. Universal screening for thyroid disorders is recommended in the first trimester of pregnancy. This study aims to determine the prevalence of thyroid disorder during pregnancy in women attending a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of Kathmandu Medical College and Teaching Hospital from March 2020 to August 2020 after obtaining ethical approval from the Institutional Review committee with reference number 20032020. The pregnant women >18 years of age, irrespective of their gestational age and gravida status, were included in the study by convenience sampling method. The participants were screened by estimation of thyroid function test. Data were collected, and statistical analysis was done in Statistical Packages for Social Services version 20.0. Results: A total of 329 pregnant women were included in this study. The prevalence of thyroid disorders in the present study is 24.62 %. The most common thyroid disorder observed was subclinical hypothyroidism comprising 65 (19.75 %) cases followed by overt hypothyroidism 8 (2.43%) cases. Conclusions: There is a high prevalence of thyroid disorders during pregnancy in our settings. Timely screening of pregnant women helps in the early diagnosis and management of complications related to thyroid disorders.    

scholarly journals A study of prevalence of thyroid disorders in type 2 diabetic patients in tertiary care hospital

2018 ◽  
Vol 5 (6) ◽  
pp. 1383
Author(s):  
K. Sankar Reddy ◽  
E. Pragnanjali ◽  
M. Dorsanamma ◽  
M. V. Nagabushana
Keyword(s):  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Low T3

Background: Insulin and thyroid being intimately involved in cellular metabolism, excess or deficit of one of these hormones leads to abnormality of the other. Association between type 1diabetes and hypothyroidism may be autoimmune. Association of poorly controlled diabetes and thyroid results in a low T3 state and loss of TSH response to TRH. The objective of the present endeavor is to study the thyroid functions in diabetics and to know the spectrum of thyroid dysfunction in DM.Methods: It is a prospective cross-sectional study of 100 diabetic patients admitted in medical wards in a duration of 6 months from November 2017 to May 2018 of both sexes in between age group of 30-80years. All these patients underwent thyroid profile tests. Detailed history and examination done on these patients.Results: Out of total 100 patients included in the study, thyroid disorder was present in 29%. Hypothyroidism in 1 patient, sub clinical hypothyroidism in 15 patients, hyperthyroidism was present in 13 patients. Females (36%) had high incidence than males (22%). Elderly people had higher incidence of subclinical hypothyroidism (18.2%), clinical features of hyperthyroidism present in 8 patients, Poor hypoglycemic control seen in hyperthyroid individuals (55.5%). Duration of diabetes had no relation with incidence of thyroid disorders.Conclusions: Prevalence of thyroid disorders in diabetic patients was 29%. Elderly population had more incidence. Subclinical hypothyroidism more common than other conditions. It was more common in females than in males. There is no relation in between duration of diabetes and thyroid disorder. Severe complications were noted in patients with sub clinical hypothyroidism.

scholarly journals Thyroid disorders in patients with abnormal uterine bleeding in tertiary care hospital in Chengalpattu district

2020 ◽  
Vol 9 (9) ◽  
pp. 3847
Author(s):  
S. Tamilarasi ◽  
S. N. S. Minnalkodi ◽  
Geetha Prasad
Keyword(s):  
Thyroid Dysfunction ◽  
Histopathological Examination ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Menstrual Dysfunction

Background: A relationship between the thyroid gland and the gonads is suggested by far more frequent occurrence of thyroid disorders in women than in men by clinical appearance of goiter during pregnancy, puberty, and menopause. Aim of this study was to determine the association between menstrual irregularities and thyroid dysfunction. To analyse the pattern of menstrual dysfunction among women with a thyroid disorder.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over 6 months in the year 2019. 100 women who presented with abnormal uterine bleeding with the below exclusion criteria. Detailed history taking with an emphasis on age, parity, infertility, and menstrual disorders. Evaluation by pelvic examination along with the general physical examination of those with menstrual complaints. Routine investigations like Hb, BT, CT, TLC, DLC, platelet count, and ABO-Rh in all. Then all patients were subjected to estimation of serum T3, T4, TSH with early morning samples.Results: Menorrhagia presents in 39.4% of patients in the normal cohort and 63.6% in the thyroid dysfunction cohort. Hypomenorrhea presents in 4% normal cohort and 9.1% thyroid dysfunction cohort. Hypothyroidism presents in 7.27%, subclinical hypothyroidism in 1.81%, and hyperthyroidism in 0.92% of patients. Amenorrhoea presents in 16.2% of patients of the normal cohort and 9.1% of patients of thyroid dysfunction cohort. No statistical significance between amenorrhoea and thyroid dysfunction.32.3% in the normal cohort and 36.4% in thyroid dysfunction cohort had a bulky uterus. No statistical association exists between thyroid dysfunction and uterine size. In a histopathological examination of the endometrium, 49.5% in the normal cohort and 54.5% thyroid dysfunction cohort reported as proliferative endometrium. Amenorrhoea; the significant association between abnormal uterine bleeding and thyroid disorder (10%).Conclusions: The significant association between abnormal uterine bleeding and thyroid disorder (10%). It brings into focus the increased incidence of hypothyroidism among women with menorrhagia.

scholarly journals A hospital based retrospective study of thyroid disorders on obstetric and perinatal outcomes

2020 ◽  
Vol 9 (11) ◽  
pp. 4590
Author(s):  
Sagar R. Patel ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta ◽  
Bina M. Raval ◽  
Viditsinh P. Sisodiya ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Free T4

Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients.

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

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