TO REVIEW THE TIMING OF INTERVENTION WHICH WILL PROVIDE THE BEST OUTCOME IN HYPOTHYROIDISM IN PREGNANCY

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Archana Mohana ◽  
Dr. Sujata Badoniya
Keyword(s):  
Pregnant Women ◽  
Thyroid Disease ◽  
Fetal Outcome ◽  
Thyroxine Therapy ◽  
In Pregnancy

The Aim of this study is to Review the timing of intervention which will provide the Best Outcome in Hypothyroidism in Pregnancy. Hypothyroid pregnant women are appropriately managed with regular antenatal checkup and thyroxine therapy during pregnancy, a good maternal and fetal outcome can be achieved and congenital cretinism and other neuro developmental sequele in the offspring can be averted. Keywords: Intervention, Hyperthyroidism, Pregnancy & Thyroid disease.

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 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 An observational study of maternal and fetal outcome in pregnant women with Hepatitis E

2019 ◽  
Vol 8 (8) ◽  
pp. 3110
Author(s):  
Ranjana Mishra ◽  
Arun H. Nayak ◽  
Madhuri Mehendale
Keyword(s):  
Hepatic Encephalopathy ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Mode Of Delivery ◽  
Research Work ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Medical Complication ◽  
Neonatal Deaths ◽  
In Pregnancy

Background: Hepatitis E in pregnancy has been a subject of interest in the recent years as the available research work is very limited and conflicting especially in pregnant women as compared to infection in men and non- pregnant women in which the disease is usually self- limiting. The mechanism of liver injury in hepatitis E is not clear and no conclusive theories about the exact pathogenesis are available. This study was done to gain insight into the effects of hepatitis E virus on pregnancy in terms of maternal and fetal outcome.Methods: Total of 40 pregnant women with Hepatitis E Virus IgM antibodies was included in the study. Hepatitis cases due to other viral and non-infective causes were excluded. Maternal outcomes in terms of mode of delivery, complications like PPH, hepatic encephalopathy, fulminant hepatic failure, coagulopathy and maternal mortality was studied. Fetal outcomes in terms of intrauterine fetal deaths, stillbirth, live births, and neonatal deaths were studied.Results: This study showed high mortality rates (42.5%) in pregnant women with hepatitis E. The most common obstetric complication was IUFD (45%) followed by preterm labor (32.5%) and postpartum hemorrhage (22.5%). Hepatic encephalopathy (62.5%) was the commonest medical complication followed by coagulopathy (25%). A statistically significant association was found between the presence of medical complications and poor maternal outcome.Conclusions: Hepatitis E virus infection in pregnancy often has a fulminant course with poor maternal and fetal outcome. Its management therefore requires an early diagnosis, and a multidisciplinary approach.

scholarly journals Maternal Outcome of Anemic Pregnant Mother at Private Hospitals in Dhaka City

2021 ◽  
Vol 33 (2) ◽  
pp. 102-107
Author(s):  
Muhammad Zahangir
Keyword(s):  
Pregnant Women ◽  
Total Sample ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Dhaka City ◽  
College Hospital ◽  
Private Hospitals ◽  
Medical College ◽  
Medicine Today ◽  
In Pregnancy

Introduction: The study carried out among the pregnant women who had anemia during pregnancy with the objectives to determine their maternal outcome at private hospitals in Dhaka city. Materials and Methods: The total sample size was 110. Data was collected by interviewing the respondents with a structured pre-tested questionnaire. The study was conducted in pregnant women with anemia at or after 28 weeks of gestation and had delivered at Obstetrics Department of Ad-Din Barrister Rafique ul-Huq Hospital, Jurain and Bashundhara Ad-Din Medical College Hospital South Keranigonj. Results: Most of the respondents (38.2%) belonged to the age group between 16-20 years. The mean age was 23.74±5.127 years. Almost (49.1%) up to primary & (38.2%) were up to secondary/higher secondary level. Most of the respondents were homemaker (87.3%); Monthly income means was 19340.91±12459.647. Most (90.9%) of the respondents had received ANC and 79.1% respondent’s hemoglobin level was below 10 gm. /dl. Among them 90.9% of the respondent’s fetal outcome were healthy & alive baby. More than half (51.8%) of the respondent’s baby were _ 2.5 kg birth weight. Study also shows that 55.5% respondents had anemia after delivery, 28.2% had sickness and 22.7% were sulfured with complications after delivery. There was a significant relationship with low birth weights (LBW) to less high education. Conclusion: All women should be given advice regarding diet in pregnancy with details of foods rich in iron. Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary. Medicine Today 2021 Vol.33(2): 102-107

Fetomaternal outcome and raised bilirubin level in pregnancy

2017 ◽  
Vol 6 (2) ◽  
pp. 710
Author(s):  
Ruchi Joshi ◽  
Nilesh Dalal
Keyword(s):  
Maternal Mortality ◽  
Pregnant Women ◽  
Bilirubin Level ◽  
Rural Areas ◽  
Serum Bilirubin ◽  
Kidney Injury ◽  
Fetal Outcome ◽  
Serum Bilirubin Level ◽  
In Pregnancy

Background: Jaundice in pregnancy has potentially serious consequences for maternal and fetal health. The cardinal features of hepatobiliary disease may include jaundice, pruritus, abdominal pain; nausea, vomiting, and a variety of liver biochemical test abnormalitiesChallenges involve making the diagnosis and the methods of treatment and their safety for both the mother and the baby.Methods: Based on inclusion criteria, 120 pregnant women were selected from Department of Obstetrics & Gynecology, MGMMC and MYH Indore from 1Aug 2014 to 1st August 2015.Patients were categorized according to serum bilirubin level. Basic investigations done and associated complications studied and correlated according to the severity and degree of jaundice.Results: 60% of the patients were aged between 20 and 30 years. 54% were primigravida. 83.3% lived in rural areas while 74.27% came in emergency. Maternal mortality was found highest in the third trimester and when the serum bilirubin crossed 5mg/dl. 43.34% patients with jaundice developed acute kidney injury with serum creatinine level above the cut-off. INR was deranged in 47.5% of the patients. The most common complication seen in our study group was that of HELLP closely followed by multi organ dysfunction and encephalopathy. 67% of the patients delivered vaginally, while 20% went under LSCS. Maternal mortality was 32.5% and perinatal outcome was poor with 50% mortality and 25% nursery admission. 62% of the patients who died were referred from a peripheral health centre.Conclusions: Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Better identification and treatment of mothers and fetuses at risk may have far-reaching implications for maternal and child health. Monitored intensive care gives a long term pay off in the maternal and fetal outcome.

scholarly journals The study of maternal and fetal outcome in pregnant women with thyroid disorders

2017 ◽  
Vol 6 (8) ◽  
pp. 3507 ◽  
Author(s):  
Sreelatha S. ◽  
Seema Nadagoudar ◽  
Asha Devi L.
Keyword(s):  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

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.

scholarly journals Prevalence of Anaemia Among Pregnant Women in Third Trimester and Its Effect on Pregnancy Outcome at Tertiary Level Teaching Hospital, Birgunj

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 54-63
Author(s):  
Ravi Kumar Shah ◽  
Jagat Prasad Deep ◽  
Zarin Rahman ◽  
Pravin Shah ◽  
Neha Nayak ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Teaching Hospital ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Third Trimester ◽  
Cross Sectional ◽  
National Medical ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Background: Anaemia in pregnancy is a global health challenge. It is the commonest medical disorder of pregnancy and a major cause of morbidity and mortality in developing countries. Main cause of anaemia in obstetrics is iron deficiency. There are specific risks for the mother and the fetus such as intrauterine growth retardation, prematurity, and blood transfusion. Hence, the importance of giving iron in the antenatal period and to be continued postnatally. Objectives: The study was conducted to determine the overall prevalence of anaemia among pregnant women presenting in third trimester and its effect on pregnancy outcome. Methods: This is a cross sectional descriptive study done at National Medical College & Teaching Hospital from September 2015 to August 2016. During the study period 2048 pregnant women attended antenatal clinic in third trimester. Among 2048, 1200 were booked cases and out of these women with haemoglobin less than 11gm/dl were labeled as anaemia. The prevalence was calculated along with the maternal and fetal outcome. Result: Among 2048, 1200 were booked cases, 368 (30.66%) were anemic, 66.30% were multigravida, 67.93% in age group of 21-30 years, 284 patients came for delivery. In 14.08% patients there was preterm labour, apgar score less than 7 in 66.19% babies. Majority of neonate weighed between 2.0 - 2.5kg (49.29%). Perinatal deaths were 2.81%. Conclusion: Anaemia in pregnancy need awareness about early and regular antenatal care with oral iron supplementation. Correction of anaemia will reduce the maternal and fetal complications.  

scholarly journals Compassionate use of remdesivir in pregnancy: a case series

2021 ◽  
Vol 10 (10) ◽  
pp. 3950
Author(s):  
Jui R. Shah ◽  
Khushali P. Parikh ◽  
Aayushi A. Suthar ◽  
Sushma R. Shah ◽  
Supriya D. Malhotra
Keyword(s):  
Pregnant Women ◽  
Birth Defects ◽  
Treatment Options ◽  
Antiviral Drug ◽  
Case Series ◽  
Fetal Outcome ◽  
Limited Data ◽  
Compassionate Use ◽  
Healthcare Crisis ◽  
In Pregnancy

Coronavirus disease 2019 (COVID-19) has resulted in an unprecedented global healthcare crisis. One special population that poses a challenge is pregnant women with COVID-19. However, there is limited data on treatment options for severe coronavirus disease in pregnancy. Remdesivir, an antiviral drug, is currently being studied as a potential treatment of COVID-19 pneumonia. Nevertheless, pregnant women are also being excluded from various clinical trials for the disease. There are some studies mentioned in the literature which have shown no adverse effects of remdesivir during pregnancy. In this study, we present four serial cases of COVID-19 in pregnant women with moderate to severe symptoms who were treated with remdesivir. All of the them showed positive fetal outcome without any birth defects or malformations. However, further studies are necessary to evaluate the biosafety and effects of remdesivir in pregnant women.

scholarly journals Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia

2020 ◽  
Vol 3 (2) ◽  
pp. 158-166
Author(s):  
Hazari Komal Sundeep ◽  
Paulose Litty ◽  
Kurien Nimmi ◽  
Mohammad Hozaifah ◽  
A Elgergawi Taghrid Faek ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Case Series ◽  
Fetal Outcome ◽  
World Health ◽  
Investigational Therapies ◽  
Serious Disease ◽  
Novel Coronavirus ◽  
Health Organization ◽  
In Pregnancy

Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray. The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure. COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome. The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.

scholarly journals Assessing the Outcome of Management of Thyroid Dysfunction in Pregnancy With Second Affiliated Hospital of Chongqing Medical University Guideline.

2021 ◽  
Author(s):  
Samuel Chigbo Obiegbusi ◽  
Xiao Jing Dong ◽  
Ming yu Deng ◽  
Chidera Nneji Obiegbusi ◽  
Yin Yang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Disease ◽  
Intrauterine Growth Restriction ◽  
Thyroid Dysfunction ◽  
Second Trimester ◽  
Intrauterine Growth ◽  
Chinese Medical Association ◽  
Significant Difference ◽  
Medical University ◽  
In Pregnancy

Abstract Introduction – Pregnancy comes with hormonal changes which, when not properly managed, could lead to complications. Thyroid hormone is one of the hormones that are affected during pregnancy, and it plays a significant role in pregnancy, from conception to delivery. In a bid to identify intended pregnant women and pregnant women with thyroid dysfunction, the Endocrinology Branch of Chinese Medical Association and Perinatal medicine branch of Chinese Medical Association set guidelines for diagnosis and treatment of thyroid diseases in pregnancy and postpartum women. The guideline recommends screening for all women who desire getting pregnant soon and pregnant women, which Second Affiliated Hospital of Chongqing Medical University is implementing.Purpose - To Identify the common thyroid disease found among pregnant women in Chongqing. Evaluate the effectiveness of the management guideline toward improving pregnancy outcome among women diagnosed with thyroid disease during their pregestational and gestational period, and ascertain the need for additional measures to be taken towards thyroid disease management during pregnancy in certain areas with unfavourable outcome.Method – A retrospective cohort study of 774 pregnant women diagnosed with thyroid dysfunction in the Second Affiliated Hospital of Chongqing Medical University from 2016 -2018 was extracted from the hospital computer patient’s record. Only 724 patients that met the inclusive criteria were analysed. Participants were grouped into four, according to the time they were diagnosed and managed. The Multiple logistic regression and binary logistic regression statistical analysis were done with SPSS, and we adjusted for potential confounders, including maternal age, parity, and gravida.Result – There is an association between maternal age and abortion among pregnant women diagnosed with subclinical hypothyroidism, P-0.018(OR 1.459, 95%CI 1.067-1.997) and significant difference in pregnant women who developed intrauterine growth restriction after being diagnosed with hypothyroidism in the second trimester, P-0.048(OR-0.152, 95%CI 0.024-0.981). There was also a significant difference in gravida, P-0.032(OR 1.368, 95%CI 1.028 1.821) and normal delivery mode, P-0.010(OR 2.521, 95%CI 1.246-5.100).Conclusion – The study shows a promising result as less complication is observed. However, more attention is needed toward managing subclinical hypothyroidism in pregnancy to curb abortion/miscarriage incidence. Hypothyroidism in second trimester could lead to intrauterine growth restriction. Multigravida increases the risk of complication among pregnant women with thyroid dysfunction.

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