scholarly journals Assessment of Thyroid Function in Early Pregnancy

2018 ◽  
Vol 19 (2) ◽  
pp. 98
Author(s):  
Mohammad Saifur Rahman ◽  
Sadia Sultana ◽  
Ayesha Nazneen

<p><strong>Objectives:  </strong>Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians.  The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.</p><p><strong>Patients and Methods: </strong>A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.</p><p><strong>Results:  </strong>Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.</p><p><strong>Conclusion: </strong>Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.</p><p>Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016</p>

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.


Author(s):  
Aditi Jain ◽  
Raksha M. ◽  
Kanakalatha D. Nakum

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.


1973 ◽  
Vol 11 (4) ◽  
pp. 13-15

With the effects of certain chemical agents and rubella in mind, most authorities advise caution in the use of all vaccines during pregnancy and especially during the first trimester. The booklet issued by the Department of Health and Social Security1 lists pregnancy as a contra-indication to rubella, smallpox and polio vaccinations, with certain provisions, and the manufacturers’ literature adds yellow fever vaccination. Pregnant women wishing to travel obviously pose a problem. Neither the doctor nor the patient may be aware of an early pregnancy and this is always a hazard when vaccinating women and girls of childbearing age. However, apart from rubella and smallpox vaccinations, the risks are hypothetical.


2020 ◽  
Vol 11 ◽  
pp. 204201882094585
Author(s):  
Samantha Anandappa ◽  
Mamta Joshi ◽  
Lukasz Polanski ◽  
Paul V. Carroll

Disorders of thyroid function are common in pregnancy and have implications for foetal and maternal health. Thyroid autoimmunity, as evidenced by the presence of elevated levels of anti-thyroid antibodies (anti-TPO and anti-Tg antibodies) is associated with an increased risk of miscarriage, though the mechanism remains poorly understood. There has been considerable focus on the implications and optimal management of pregnant women with thyroid disease, especially those undergoing assisted reproduction. Pregnancy results in significant changes in thyroid physiology and these need to be understood by clinicians involved in the care of pregnant women. Guidelines for the use of thyroxine and target thyroid function tests have been produced by international bodies but it is recognised that these predominantly reflect expert opinion rather than established evidence-based practice. Importantly a number of key clinical trials have been performed to aid understanding, particularly of the consequences of hypothyroidism for mother and baby, and the effectiveness of thyroid hormone use in autoimmune and subclinical hypothyroidism. This review summarises the current knowledge base and guidance for practice relating to thyroid disorders in pregnancy and subfertility.


Author(s):  
Sangeeta Pahwa ◽  
Sabia Mangat

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.


2016 ◽  
Vol 29 (1) ◽  
pp. 26-31
Author(s):  
Shaila Naznine Tania ◽  
Ferdousi Islam

Objective: The study was conducted to find out any alterations in thyroid function status in first half of pregnancy (up to 20 weeks), with ultimate aim of deciding the usefulness of routine screening of thyroid function in pregnancy.Material and methods: A cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, over a period of one year from July 2011 to June 2012 on pregnant women in their 1st half of pregnancy to screen for the thyroid function. Based on predefined eligibility criteria, a total of 230 pregnant women were purposively included in the study. Thyroid function status was assessed by measuring serum levels of TSH, free thyroxine (FT4), and free tri-iodothyronine (FT3). Women with thyroid disorders were excluded.Results: The mean age of the patients being 24 years. Over 90% of the women were housewife and majority (88.7%) was educated. Over one-quarter of women was overweight with mean body mass index being 22.1 ± 4.4 kg/m2. The women were predominantly multigravida with 56% in 1st trimester 44% in the 1st half of 2nd trimester of pregnancy (13-20 weeks). Based on trimester’s specific range of serum TSH in the 1st and 1st half of 2nd trimester (13-20 weeks) of pregnancy,13% of the patients were hypothyroid and 3% were hyperthyroid thus yielding a total of 37(16%) pregnant women with abnormal thyroid function status.Conclusion: The study concluded that one in every six women may have thyroid disorder in the first half of pregnancy and subclinical hypothyroidism is four times more common than the subclinical hyperthyroidism.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 26-31


Author(s):  
Bharati Das ◽  
Puspanjali Khuntia

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences.  Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid   and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.


2014 ◽  
Vol 4 (1) ◽  
pp. 15-20
Author(s):  
Ohida Sultanaa ◽  
Nasim Jahan ◽  
Nayma Sultana ◽  
Farzana Mahmudad ◽  
Tazdik G Chowdhurye

Objective: To measure the distribution of TPO-Ab positivity and to observe the effect of thyroid peroxidase positivity on thyroid function during first trimester in normal pregnancy. Method: A cross sectional among 120 subjects were taken in this study and divided into control and study groups. Control group (Group A) consisted of 60 healthy non pregnant women age ranged between 20 to 35 years. Study group (Group B) consisted of 60 normal pregnant women of same age range. Group B was further subdivided into group B1 and group B2according to the level of TPO-Ab. Group B1 consisted of TPO-Ab positive pregnant women and group B2 consisted of TPO- Ab negative pregnant women. Control group was selected from personal contacts and study group from Out Patient Department (OPD) of Obstetrics and Gynecology of Sir Salimullah Medical College and Mitford Hospital. For assessment of thyroid function, serum free thyroxine (FT4), thyroid stimulating hormone (TSH) were measured. Serum FT4, TSH were measured by Enzyme link immunosorbant (ELISA) method. Again, serum TPO-Ab of total study population and hCG of all the pregnant women were measured. Serum TPO-Ab by Micro particle Enzyme Immunoassay (MEIA) method and hCG was estimated by ELISA. Statistical analysis was done by SPSS version 17. Results: In this study, serum FT4 and was significantly (P<0.001) higher and TSH level was significantly (P<0.001) lower in normal pregnant women during 1st trimester in comparison to those of non pregnant women. Again, 18% of pregnant women showed TPO-Ab positivity. However, serum FT4 level was significantly (P<0.001) lower whereas, TSH level was significantly (p<0.001) higher in TPO-Ab positive pregnant women in comparison to those of TPO-Ab negative pregnant women. Conclusion: TPO-Ab positivity increases during 1st trimester of normal pregnancy which decreases the hyper functional state of thyroid hormones. So, thyroid screening should be done routinely during pregnancy. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21160 Update Dent. Coll. j: 2014; 4 (1): 15-20


2020 ◽  
Vol 11 ◽  
Author(s):  
Tal Schiller ◽  
Arnon Agmon ◽  
Viviana Ostrovsky ◽  
Gabi Shefer ◽  
Hilla Knobler ◽  
...  

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (&lt;150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.


2020 ◽  
Vol 4 (2) ◽  
pp. 7-11
Author(s):  
Nelfi Sarlis

Every pregnant woman in the first trimester experiences nausea and vomiting. This situation is natural and often occurs in pregnancy, especially in the first trimester. Nausea usually occurs in the morning, this case can occur almost 50% of pregnant wowen and many occur at 6-12 weeks. The purpose of this study was to determine the relationship between knowledge and attitudes of pregnant women on how to cope with vomiting nausea in pregnancy trimester 1 in the work area of ​​Payung Sekaki health center in Pekanbaru. This study uses a quantitative method with a cross sectional, so that the number of samples obtained was 71 respondents. Sampling used consecutive sampling technique, nominal and ordinal measuring scales, questionnaire research instruments and univariate and bivariate data collection. Based on the results of the chi square test obtained the knowledge variable is related to how to overcome nausea and vomiting with p = 0.008 where the value of α <0.1 then, Ha accepted means there is a relationship between knowledge and attitudes of pregnant women on how to cope with nausea vomiting while the variable obtained p=0,000 where the value of α<0,1 in the working area of ​​payung sekaki health center in Pekanbaru in 2019. Advised to puskesmas payung sekaki pekanbaru to try to increase public knowledge abaout nausea vomiting in pregnancy and the attitude of pregnant women to overcome nause and vomiting. By providing counseling to pregnant women abaout nausea and vomiting in pregnancy.


Sign in / Sign up

Export Citation Format

Share Document