scholarly journals Pregnancy and Thyroid Dysfunction: Need for Universal Screening - A Pilot Study

2013 ◽  
Vol 13 (1) ◽  
pp. 49-52
Author(s):  
M Vijayasree
Keyword(s):  
Pilot Study ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Medical Science ◽  
Early Screening ◽  
Fetal Complications ◽  
A Prospective Study ◽  
Rule Out

Aim: 1. To determine Thyroid dysfunction and antiTPO antibody status in pregnant women. 2. To know the benefit of LT4 therapy in maternal pregnancy outcome (antiTPO ab+ve vs antiTPO ab-ve groups) and 3. To determine the maternal and fetal outcomes in hypothyroid pregnant women and to decide whether universal screening of pregnant women for hypothyroidism is required or not. Materials and methods: A prospective study was done in mamata general hospital in the dept. of obg, over a period of 1 ½ years.105 antenatal women were included in the study. Outcome in these pregnancies were observed and analysed using appropriate statistical method. Results: There were only 3 patients with spontaneous abortions, 3 patients with pregnancy induced hypertention and only 1 patient had preterm delivery. There was more of thyroid dysfunction in anti TPO Ab +ve cases. But there was no significant adverse effect on pregnancy outcome in patients who were treated. Conclusion: Though our study included only a small number of antenatal women who were screened for thyroid abnormality since it was only a pilot study done in our hospital since our area is endemic for thyroid disorders due to iodine deficiency we recommend Universal screening to rule out thyroid dysfunction in pregnancy because the maternal and fetal complications can be reduced by early screening, diagnosing and correcting thyroid abnormality. DOI: http://dx.doi.org/10.3329/bjms.v13i1.14173 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 49-52

Reference values and universal screening of thyroid dysfunction in pregnant women

2014 ◽  
Vol 61 (6) ◽  
pp. 336-338
Author(s):  
Gonzalo Díaz-Soto ◽  
Encarna Largo ◽  
Cristina Álvarez-Colomo ◽  
Isabel Martínez-Pino ◽  
Daniel de Luis
Keyword(s):  
Pregnant Women ◽  
Reference Values ◽  
Universal Screening ◽  
Thyroid Dysfunction

scholarly journals Effects of levothyroxine treatment on pregnancy outcomes in pregnant women with autoimmune thyroid disease

2017 ◽  
Vol 176 (2) ◽  
pp. 253-265 ◽  
Author(s):  
Sima Nazarpour ◽  
Fahimeh Ramezani Tehrani ◽  
Masoumeh Simbar ◽  
Maryam Tohidi ◽  
Hamid Alavi Majd ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Pregnancy Outcomes ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Autoimmune Thyroid ◽  
Adverse Pregnancy ◽  
Group B

Background Despite some studies indicating that thyroid antibody positivity during pregnancy has been associated with adverse pregnancy outcomes, evidence regarding the effects of levothyroxine (LT4) treatment of euthyroid/subclinical hypothyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. We aimed to assess whether pregnant women with autoimmune thyroid disease, but without overt thyroid dysfunction are affected by higher rates of adverse pregnancy outcomes. In addition, we aimed to explore whether LT4 treatment improves the pregnancy outcome of affected women. Methods A prospective study was carried out on pregnant women from the first trimester to delivery. The study was conducted among pregnant women receiving prenatal care in centers under coverage of Shahid Beheshti University of Medical Sciences. Of a total of 1746 pregnant women, screened for thyroid dysfunction, 1028 euthyroid TPOAb-negative (TPOAb−) and 131 thyroid peroxidase antibody-positive (TPOAb+) women without overt thyroid dysfunction entered the second phase of the study. TPOAb+ women were randomly divided into two groups: group A (n = 65), treated with LT4 and group B (n = 66), received no treatment. The 1028 TPOAb− women (group C) served as a normal population control group. Primary outcomes were preterm delivery and miscarriage and secondary outcomes included placenta abruption, still birth, neonatal admission and neonatal TSH levels. Results Groups A and C displayed a lower rate of preterm deliveries compared with group B (RR = 0.30, 95% CI: 0.1–0.85, P = 0.0229) and (RR = 0.23, 95% CI: 0.14–0.40, P < 0.001) respectively. There was no statistically significant difference in the rates of preterm labor between groups A and C (RR = 0.79, 95% CI: 0.30–2.09, P = 0.64). The number needed to treat (NNT) for preterm birth was 5.9 (95% CI: 3.33–25.16) Conclusions Treatment with LT4 decreases the risk of preterm delivery in women who are positive for TPOAb.

scholarly journals Periodontal Disease and Bacterial Vaginosis Increase the Risk for Adverse Pregnancy Outcome

2005 ◽  
Vol 13 (4) ◽  
pp. 213-216 ◽  
Author(s):  
Juha Oittinen ◽  
Tapio Kurki ◽  
Minnamaija Kekki ◽  
Minna Kuusisto ◽  
Pirkko Pussinen ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Confidence Interval ◽  
Periodontal Disease ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Strong Association ◽  
Adverse Pregnancy ◽  
Rule Out

Objectives.To determine whether periodontal disease or bacterial vaginosis (BV) diagnosed before pregnancy increase the risk for adverse pregnancy outcome.Methods.We enrolled a total of 252 women who had discontinued contraception in order to become pregnant. The first 130 pregnant women were included in the analyses.Results.Multivariate analysis showed a strong association between periodontal disease and adverse pregnancy outcome (OR 5.5, 95% confidence interval 1.4–21.2;p= 0.014), and a borderline association between BV and adverse pregnancy outcome (OR 3.2, 95% confidence interval 0.9–10.7;p= 0.061).Conclusion.Our study suggests that pre-pregnancy counseling should include both oral and vaginal examinations to rule out periodontal disease and BV. This may ultimately have an impact on antenatal healthcare, and decrease the risk for adverse pregnancy outcome.

scholarly journals Prevalence of thyroid dysfunctions in pregnant women: a prospective study in a tertiary care hospital in Maharashtra, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3211
Author(s):  
Vaishali R. Korde ◽  
Sharin P. Barse ◽  
Jaya S. Barla
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Total Sample ◽  
Adverse Outcomes ◽  
Sample Population ◽  
Care Hospital ◽  
A Prospective Study ◽  
In Pregnancy

Background: Thyroid dysfunction is known to be the commonest endocrinological disorder in pregnancy. A range of adverse outcomes in pregnant women and the fetus have been reported. These can be prevented if the thyroid dysfunction is diagnosed and treated as early as possible. There are limited studies conducted on the prevalence of thyroid dysfunction in pregnancy in India. Hence, this study was conducted for assessment of the prevalence of thyroid dysfunction in pregnancy.Methods: The present study is a prospective study conducted in the Department of Obstetrics and Gynecology, MIMER Medical College and Hospital, Talegaon, Dabhade, Maharashtra. The total sample population comprised of 705 pregnant women with uncomplicated singleton intra-uterine pregnancy. All participants were screened by estimation for serum TSH in first trimester.Results: The prevalence of thyroid dysfunction in the present study is 13.9%. Of this, prevalence of hypothyroidism is 12.76% and that of hyperthyroidism is 1.13%.Conclusions: With this study, we conclude that there is high prevalence of thyroid dysfunction in pregnancy even in rural population. Thus, a universal screening helps in early diagnosis and preventing the aftermaths of thyroid dysfunction in pregnancy.

Detection of thyroid dysfunction in pregnant women: Universal screening is justified

2012 ◽  
Vol 59 (9) ◽  
pp. 547-560 ◽  
Author(s):  
Lluís Vila ◽  
Inés Velasco ◽  
Stella González ◽  
Francisco Morales ◽  
Emilia Sánchez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Universal Screening ◽  
Thyroid Dysfunction

scholarly journals A study on pregnancy outcome in patients with first trimester vaginal bleeding

2019 ◽  
Vol 8 (3) ◽  
pp. 820
Author(s):  
Kavyashree H. S. ◽  
Rajeshwari K.
Keyword(s):  
Pregnant Women ◽  
Vaginal Bleeding ◽  
Placenta Previa ◽  
First Trimester ◽  
Perinatal Complications ◽  
Medical College ◽  
Fetal Complications ◽  
Predicting Factor ◽  
A Prospective Study ◽  
Structured Questionnaire

Background: Vaginal bleeding is a common obstetric problem and a cause of anxiety and worry both to patients and the Obstetrician. The common cause of bleeding in 1st trimester include various types of abortion, ectopic pregnancy and molar pregnancy. This study was conducted to assess the maternal and perinatal outcome in pregnant women who present with first trimester vaginal bleeding.Methods: A Prospective study (Longitudinal study) among pregnant women presenting with First trimester bleeding was conducted for a period from November 2017 to Jan 2019 at Mysore Medical College and Hospital 200 subjects were included into the study by Multiphasic sampling method using a structured questionnaire to collect the data.Results: The study observed that among 200 subjects who were included in the study 123 (61.5%) were non-viable pregnancy and 67 (38.5%) were viable pregnancy. Among 67 viable pregnancy only 30 (47%) had no obstetrical complications, 11 (17.1%) aborted and others had problems of PROM, Preterm labour, Placenta previa, IUGR and IUD.Conclusions: It can be concluded that first trimester bleeding is a predicting factor for obstetric and perinatal complications during pregnancy. Hence it is necessary to increase the knowledge of pregnant women in this regard for closer care. It is also important factor for clinician to be attentive towards first trimester bleeding in providing clinical interventions for the continuation of pregnancy and also reducing the fetal complications in these high-risk pregnancies.

scholarly journals Prevalence of thyroid dysfunction in pregnant women and the need for universal screening: an observational study in Northern Andhra Pradesh population

2017 ◽  
Vol 6 (6) ◽  
pp. 2536
Author(s):  
Krishnamma B. ◽  
Prabhavathi V. ◽  
Prasad D. K. V.
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Increased Risk ◽  
Tsh Levels

Background: The maternal thyroid dysfunction is associated with adverse outcomes such as miscarriage, preterm delivery, preeclampsia, postpartum haemorrhage in mother whereas increased risk of impaired neurological development in foetus. The present study was designed with an aim to determine the prevalence of thyroid dysfunction and the need for universal screening in pregnant women.Methods: Three hundred and eighty pregnant women between 8-36 weeks of gestation with age group 20-32 years were recruited. Serum free T3, free T4 and TSH levels were assayed by chemiluminescence method. The pregnant women were classified into euthyroid, subclinical hypothyroid (SH), overt hypothyroid (OH) and overt hyperthyroid groups based on the results obtained in the study.Results: In the present study, the mean ± SD age (in years) and BMI of all pregnant women was 23.9±3.9 and 22.9±1.6 respectively. The maternal age was high in OH and overt hyperthyroid and was statistically significant (p<0.05). Similarly, women with high BMI were prone to OH than normal BMI (p<0.05). The prevalence of thyroid dysfunction was found to be 18.7%. The prevalence of hypothyroidism was 17.4% in which the SH was 13.4% and overt hypothyroidism 3.9%, but overt hyperthyroidism was 1.3%. TSH levels increased with the advancement of gestational age from 2.72±1.85 in first trimester to 3.4±2.05 µIU/mL in third trimester, and the difference was statistically significant (p<0.05). Finally, it was also noticed that the prevalence of raised TSH in high-risk pregnant women was high compared to low-risk women (35.6% vs 5.1%) relative risk (RR) 7.64, 95% confidence interval (CI) 4.62-12.65, (p<0.0001). However, 14 out of 51 (27.5%) with SH were in low-risk group.Conclusions: The present study states that the prevalence of thyroid dysfunction was 18.7% and also emphasizes the importance of screening all pregnant women for thyroid dysfunction rather than targeted high-risk pregnant women to prevent both maternal and fetal morbidity.

scholarly journals Comparison of universal screening with targeted high-risk case finding for diagnosis of thyroid disorders

2016 ◽  
Vol 174 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Sima Nazarpour ◽  
Fahimeh Ramezani Tehrani ◽  
Masoumeh Simbar ◽  
Maryam Tohidi ◽  
Hamid AlaviMajd ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Pregnant Women ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Risk Group ◽  
Case Finding ◽  
High Risk Group ◽  
Thyroid Status ◽  
High Risk Case

ObjectiveDebate about the need for universal screening of thyroid dysfunction in pregnancy is ongoing. The present study aimed to compare universal screening with targeted high-risk case findings for early diagnosis of thyroid disorders in Iranian pregnant women.Study designThis cross-sectional prospective study was carried out on 1600 pregnant women in their first trimester. A checklist, including all related risk factors recommended by The American Thyroid Association, was completed for all participants. Serum concentrations of thyroxine (T4), T-uptake, TSH and thyroid peroxidase antibody (TPOAb) were measured and thyroid status was documented, based on hormonal measurements and clinical examinations.ResultsThere were 656 women (44.3%) that had at least one risk factor for thyroid diseases and were eligible for the targeted high-risk case finding (high-risk group) approach, while 55.7% had no risk factors (low-risk group). Using the universal screening approach, there were 974 women (65.8%) with normal thyroid status and 506 participants (34.2%) with thyroid disturbances, including overt hyperthyroidism (0.7%), overt hypothyroidism (1.1%), subclinical hypothyroidism (30.1%; positive TPOAb (5.5%) and negative TPOAb (24.6%); and euthyroid and positive TPOAb (2.3%). Of women with thyroid dysfunction, 64.4% were in the high-risk group and 35.6% were in the low-risk group (P<0.0001).ConclusionsThe targeted high-risk case finding approach overlooks about one-third of pregnant women with thyroid dysfunction. If ongoing prospective trials provide evidence on the efficacy of treating subclinical hypothyroidism in pregnancy, in populations with a low prevalence of presumed risk factors, the targeted high-risk case finding approach will be proven inefficient.

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