Subclinical Hypothyroidism (SCH) in the First Trimester of Pregnancy: A Cross-Sectional Study at a Tertiary Care Hospital

2021 ◽  
Vol 15 (8) ◽  
pp. 1855-1857
Author(s):  
Israr-Ul- Haq ◽  
Junaid Mushtaq ◽  
Atiq Ahmad ◽  
Waqas Mahmood ◽  
Mujtaba Hasan Siddiqui ◽  
...  

Aim: To evaluate and assess the prevalence along with its related complications of subclinical hypothyroidism in pregnant ladies during the 1st trimester of pregnancy in Pakistani population. Study design: Cross sectional study Place and duration of study: Department of Medicine, Unit-1 of Lahore General Hospital, Lahore, Pakistan from 11th February 2019 to 29th December 2019. Methodology: Four hundred and fifty seven pregnant women with a gestational age up to 12th week with an age group between 18-45 years were included in this study. Blood samples were collected for free triiodothyronine, free thyroxine and thyroid stimulating hormone levels. Patients were regularly followed at an interval of 4 weeks for their entire pregnancy period. Adverse events and complications were noted. Results: One hundred and sixty nine subjects had TSH levels above the normal range i.e., 4.6-10mIU/L. 288 subjects were having TSH below 4 mIU/L levels. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, abruptio placentae and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Higher prevalence of subclinical hypothyroidism (SCH) in the first trimester of pregnancy indicates that these women are at increased risks of loss of pregnancy, placental abruption and neonatal death as compared to euthyroid pregnant women. Keywords: First trimester; pregnancy; subclinical hypothyroidism

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Dipty Shrestha ◽  
Rachana Saha ◽  
Chandrima Karki ◽  
Shilpi Mahato

Introduction: Vitamin-D deficient pregnant women are more likely to have pregnancy complications like pre-eclampsia, intrauterine growth restriction, diabetes, preterm birth, etc. Associated factors include ethnicity, skin coverall, use of sun protection, overweight, vitamin-D intake, and smoking. The objective of this study is to determine the prevalence of Vitamin-D deficiency among pregnant women in a tertiary level hospital. Methods: This study descriptive cross-sectional study was conducted at a tertiary care hospital from September 15th, 2020 to November 15th, 2020 where the pregnant women visiting for an antenatal checkup in the first trimester were enrolled. Ethical clearance was taken from the Institutional Review Committee of Kathmandu Medical College (reference no. 1808202003). A convenience sampling method was used. All the data were entered in the Statistical Package of the Social Sciences version 20.0 and analyzed. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among a total of 47 cases, vitamin-D deficiency was seen in 21 (44.6%) (32.67-56.52 at 90% Confidence Interval). Conclusions: The prevalence of vitamin-D deficiency was similar to other studies done in similar settings.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ishara P. Premathilake ◽  
Praveena Aluthbaduge ◽  
Channa P. Senanayake ◽  
Renuka Jayalatharachchi ◽  
Sirithilak Gamage ◽  
...  

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Jyotshna Sharma ◽  
Sanjeeb Tiwari

Introduction: The sedentary lifestyle of women and change in their food habits has a significantrole in developing diabetes in pregnancies. This leads to an increased chance of fetal cardiacabnormality born by a mother with gestational diabetes and pre-existing diabetes. The objectiveof the study is to find out the prevalence of abnormal fetal echocardiography in gestational andpre-existing diabetic pregnant women at a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 104 diabetic pregnantwomen in a tertiary care hospital from April 15, 2017, to April 14, 2018. Ethical approvalwas obtained from the institutional review committee. The convenient sampling method wasused. The patients who were diagnosed as gestational diabetes and diabetic before pregnancywere included in the study. Fetal echocardiography was mainly done at a gestational age of22-32 weeks depending upon the time of diagnosis of gestational diabetes and for pre-diabeticwomen, fetal echocardiography was done at 24-26 weeks of gestation. Statistical analysis wasdone using the Statistical Package of the Social Sciences version 20. Results: Among 104 patients, 16 (15.38%) patients had abnormal fetal echocardiography.Eighty-three (79.81%) were gestational diabetics, 21 (20.19%) were pre-existing diabeticwomen. Among 83 gestational diabetes, 7 (8.4%) had abnormal echo finding and among 21pre-existing diabetics, 9 (42.8%) had abnormal echo finding. Conclusions: There was an increased chance of fetal cardiac malformation in gestational diabeticand pre-existing diabetics diabetic especially in an uncontrolled glycemic state. And, if theywere diagnosed prenatally, clinical outcomes for both mother and fetus would have been better.


Author(s):  
Laxmi Poonia ◽  
Swati Kochar ◽  
Shweta Chaudhary ◽  
Priyanka Gaur ◽  
Kirti Solanki

Background: Hypertensive disorders of pregnancy, including preeclampsia complicates about 10% of pregnancies worldwide. Preeclampsia is one of the major cause of maternal and perinatal morbidity and mortality worldwide. According to the National Health Portal of India, the incidence of preeclampsia is reported to be about 8-10% among pregnant women. The present study was aimed to compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation and assess relationship between maternal serum calcium levels, severity of disease and overall maternal and perinatal outcome.Methods: This was a cross sectional study conducted on 200 females divided into two groups (i.e. Study and Control Group) from 1st November 2019 to 31st October 2020. Informed consent was obtained for subjecting. Detailed history and clinical examination were performed. Serum calcium level was measured in both groups by spectrophotometric method.Results: Mean serum calcium level in study group (preeclamptic) was 7.84+0.74mg/dl while in control group (normotensive) mean serum calcium level was 9.68+0.97mg/dl. Serum calcium level was significantly lower in preeclamptic women than normotensive pregnant women (p<0.001).Serum calcium showed significant negative correlation with systolic and diastolic blood pressure.Conclusions: This study concludes that hypocalcaemia may have a role in aetiology of preeclampsia and adverse maternal and perinatal outcome. Thus intake of calcium supplements may help in reduction of incidence of preeclampsia especially in a population of a developing country. 


Author(s):  
Ashok Kumar ◽  
Geeta Yadav ◽  
Vijay Zutshi ◽  
Suman Bodat

Background: According to UNICEF, globally 800 million women die due to preventable causes related to pregnancy and childbirth; 20% of which occur in India. It is therefore imperative to understand the level of knowledge about danger signs among pregnant women to augment timely redressal of preventive obstetric causes of mortality.Methods: A hospital based, cross sectional study was conducted at the ANC Clinic in Safdarjung Hospital, New Delhi from 2nd July to 27th July 2018. Convenient sampling was used to identify and interview 354 pregnant women, using a semi structured questionnaire. Data was entered and analysed with SPSSv21. Results were presented as frequencies and proportions. Chi square was used to test for association between qualitative variables, and p-value less than 0.05 was considered significant.Results: 48.3%, 35.6%, and 40.1% of pregnant women had knowledge about danger signs during pregnancy, labour and postpartum respectively. Majority of the women had knowledge about abdominal pain (58.4%) and severe fatigue (80.7%) as danger signs of pregnancy, while bleeding (82.5%) was the most common response as danger sign of labour. More than half had knowledge about heavy bleeding (59.9%) as danger sign of postpartum. The women lacked awareness about Convulsions (92.9%) as danger signs of pregnancy and labour, as well as smelly vaginal discharge (79.6%) in postpartum.Conclusions: Knowledge of obstetric danger signs among pregnant women is still lower. It needs further awareness as it can help in early diagnosis and referral of patients thus reducing maternal mortality and morbidity.


2020 ◽  
Vol 59 (233) ◽  
Author(s):  
Gita Khakurel ◽  
Chandrima Karki ◽  
Sanat Chalise

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.    


Author(s):  
Neeta Banzal ◽  
Kirti Saxena ◽  
Malti Dalal ◽  
S. K. Srivastava

Background: The present study was conducted with an objective to assess the awareness of drug use in pregnancy, to assess the knowledge of pregnant women on effect of drugs on foetus and to assess the self-medication among pregnant women.Methods: This was a prospective, observational, cross-sectional study conducted on randomly selected 200 pregnant women attending a tertiary care hospital in Surat, Gujarat, India. Data was collected by means of a pre-designed semi-structured questionnaire composed of 26 questions on self-medication during pregnancy and knowledge about that. The data was collected by interview technique in which each participant was asked questions in the language of her understanding in a separate room.Results: The average age of the participants was 23.7±3.68 years. About 91% were not aware about the effect of medication on the health of foetus and did not even enquire about it.  At the time of survey, 74% pregnant women were on some kind of medication. More than 80% were not aware about the duration of medication. About 51% were taking medication on regular basis. The proportion of self-medication among pregnant women was 8.5% (includes 5.5% by themselves and 3% by advice of chemists).Conclusions: There is a lack of awareness amongst the pregnant women regarding the effect of the drugs on the health of foetus. More than half of the women take medication on regular basis. However, low proportion of self-medication during pregnancy suggests that during pregnancy women preferred to take advise of physician for medication rather than taking self-medication.


2020 ◽  
Vol 27 (11) ◽  
pp. 2474-2477
Author(s):  
Kashif Ali Khan ◽  
Muhammad Saleem Akhter ◽  
Kehkashan Fatima ◽  
Muhammad Waqar Saleem

Objectives: The prime objective of this study was to evaluate and asses the prevalence and related complications of SCH in pregnant ladies in their 1st trimester of pregnancy in Pakistani population. Study Design: Cross Sectional study. Setting: Department of Medicine, Teaching Hospital, DG Khan, Pakistan. Period: 11th February 2017 to 29th December 2018. Material & Methods: We obtained informed consent from all patients. 457 pregnant ladies having last missed period till 12th week with age group between 18-45 years were included in this study. Samples were collected for T4 (Thyroxine), TSH (Thyroid Stimulating Hormone) and T3 (Triiodothyronine). Patients were followed for their entire pregnancy period.  Adverse events and complications were noted. Results: Out of 457 patients who were included in our study, 169 subjects had TSH levels well above 4.6- 10 mIU/L. 288 subjects were having TSH levels below 4 mIU/L. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Our study concludes that overall prevalence of subclinical hypothyroidism (SCH) in Pakistani pregnant women during their first trimester of pregnancy was found to be 37%. Pregnant women having subclinical hypothyroidisms (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. In the light of these findings we recommend routine screening for TSH, free T3 and free T4 during pregnancy especially during 1st trimester of pregnancy.


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