MATERNAL AND FETAL OUTCOME AMONG PREGNANT WOMEN PRESENTING WITH HYPOTHYROIDISM.
- M.D (OBG),Associate Professor,Department of Obstetrics &Gynecology,DrRajendera Prasad GovernmentMedicalCollegeKangra,Himachal Pradesh.
- M.S (OBG),Medical Officer, Department of Obstetrics &Gynecology,DrRajendera Prasad Government Medical College Kangra.
- M.S (OBG),Senior Resident, Department of Obstetrics &Gynecology,DrRajendera Prasad Government Medical College Kangra.
- M.D (OBG),Professor&Head, Department of Obstetrics &Gynecology,DrRajendera Prasad Government Medical College Kangra.
- M.B.B.S,Junior Resident (OBG), Department of Obstetrics &Gynecology,DrRajendera Prasad Government Medical College Kangra.
- Abstract
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Background:Thyroid disorder is the second most common endocrine disorder affecting women of reproductive age. The increased prevalence of thyroid dysfunction in pregnancy and the need for proper management to reduce obstetrical and neonatal adverse events led us to collect the baseline data on hypothyroidism in pregnancy in our population. Material and methods: A total of 1203 consecutive pregnant women attending antenatal clinic in our hospital and consented to participate were studied. All women were tested for TSH levels (determined by chemiluminescent enzyme immunoassay) . Women having higher than normal range of TSH (>2.5mIU/L in first trimester and >3.0mIU/L in second trimester were further tested with repeat TSH & T4. Results: 118 (9.8%) were found to be hypothyroid. The mean age of the women was 26.2?3.7years. 21.2% women had history of previous one or more spontaneous abortions, 15.3% had history of infertility. Symptoms of hypothyroidism were present in 33.9% women, 4.2% women had goiter. Mean BMI was 26.1kg/m2. 72.9% were newly diagnosed in current pregnancy and 27.1% were known cases of hypothyroidism. 18.1% women had pregnancy induced hypertension, 11.9% had preterm labor, and 10.2% each had placental abruption and premature rupture of membranes. 7.6% women had intrauterine growth restriction. Caesarean rate was 41.5% of which 54% were for foetal distress. 16% of neonates were admitted to NICU. Conclusions: Based on the results of this study, we recommend universal screening of hypothyroidism in pregnancy for early diagnosis and treatment of this potentially treatable condition complicating pregnancy.
- Goel P, Kaur J, Saha PK, Tandon R, Devi L. Prevalence, associated risk factors and effects of hypothyroidism in pregnancy: A study from North India. GynecolObstet Invest 2012; 74:89-94
- Negro R, Stagnaro-Green A. Diagnosis and management of subclinical hypothyroidism in pregnancy. BMJ2014; 349-g4829 doi: 10.1136/mbj.g4929
- Kapil U, Sohal KS, Sharma TD, Tandon M, Pathak P. Assessment of Iodine deficiency disorders using the 30 cluster approach in district Kangra, Himachal Pradesh. J Trop Pediatr 2000; 46(5):264-6
- Kapil U, Sharma TD, Singh P. Iodine status and goitre prevalence after 40 years of salt iodisation in the Kangra District, India.Indian J Pediatr 2007;74(2):135-7
- Dhanwal DK, Prasad S, Agarwal AK, Dixit V, Banerjee AK. High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India. Indian J EndocMedtab 2013; 17:281-4
- Nuzhat A, Pranathi R, Evita F. Hypothyroidism in pregnancy: Is universal screening needed? J ObstetGynecolInd 2006; 56(6):495-98
- Kumar A, Singh R, Prasad S. Hypothyroidism during pregnancy. Int J GynaecolObstet 2004; 84:252-3
- Poulasouchidou MK, Goulis DG, Poulakos P, Mintziori G, Athanasiadis G, Tarlazis BC. Prediction of maternal and neonatal outcomes in pregnant women treated for hypothyroidism. Hormones 2012; 11(4); 468-76
- Chen L-M, Du WJ, Dai J, Zhang Q, Si G-X et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: A single-centre cohort study of a Chinese population. PLoS ONE 9(10):e109364. Doi 10:10.1371/journal.phone.0109369
- Sharma PP, Mukhopadhyay P, Mukhopadhyay A, Muraldharan PD, Begum N. Hypothyroidism in pregnancy. J ObstetGynecolInd 2007; 57(4):331-4
- Nambiar V, Jagtap VS, Sarathi V, Lila AR, kamalanathan S, Bandgar TR, et al. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant women. J Thyroid Res 2011; 2011:1-6
- Albovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 2002; 12(1):63-8
- Horacek J, Spitalnikova S, Dlabalova B, Malirova E, Vizda J, Svilias I et al. Universal screening detects two-times more thyroid disorders in early pregnancy than high risk case finding. Eur J Endocrinol 2010; 163:645-50
- Matuszek B, Zakoscienlna K, Basak-Radomanska E, Pyzik A, Nowakoski A. Universal screening as a recommendation for thyroid tests in pregnant women. Ann Agric Environ Med 2011 Dec; 18:375-9
- Vaidya B, Anthony S, Bilous M, Shields B, Drury J, Hutchinson S, et al. Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? J ClinEndocrinolMetab 2007; 92:203-7
- Alexander EK, Marqusee E, Lawrence J, Jarolim P, Fischer GA, Larsen PR. Timing and magnitude of increase in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med 2004; 351(3):241-9
- Mandel SJ, Larsen PR, Seely EW, Brent GA. Increased need for thyroxine during pregnancy in women with hypothyroidism. N Engl J Med 1990 Jul 12; 323(2):91-6
- Lazarus JH, Bestwick JP, Channon S, Paradice R, Maina A, Rees R, Etal.Antenatal thyroid screening and childhood function. N Engl J Med 2012; 366:493-501
- Yu X, Chen Y, Shan Z, Teng W, Li C, Zhow W, et al. The pattern of thyroid function of subclinical hypothyroid women with levothyroxine treatment during pregnancy. Endocrine 2013; 44:710-5
- Abalovich M, Vazquez A, Alcaraz, Kitagrodsky A, Szuman G, Calabrese C, et al. Adequate levothyroxine doses for the treatment of hypothyroidism newly diagnosed during pregnancy. Thyroid 2013; 23:1478-83
- Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Lenevo KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. ObstetGynecol 2005; 105:239-45
- Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A. Maternal and perinatal outcome in pregnancy with hypothyroidism. Ind J Med Sci 2005; 59(3):116-7
- Wolfberg AJ, Lee-Parritz A, Peller AJ, Liberman ES. Obstetric and neonatal outcomes associated with maternal thyroid disease. J Matern Fetal Neonatal Med 2005 Jan; 17(1):35-8
- Sahu MT, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch GynecolObstet 2010 Feb; 281(2):215-20
- Mannisto T, Mendola P, Reddy U, Laughon SK. Neonatal outcomes and birth weight in pregnancies complicated by Maternal Thyroid Disease. Am J Epidemiol 2013; 178(5):731-740.
[Ashok Verma, Dipen Parekh, Meenakshi Verma, Suresh Verma, Ruchi Shah and Kranti Bishat. (2019); MATERNAL AND FETAL OUTCOME AMONG PREGNANT WOMEN PRESENTING WITH HYPOTHYROIDISM. Int. J. of Adv. Res. 7 (Feb). 1098-1107] (ISSN 2320-5407). www.journalijar.com
Department of Obstetrics & Gynaecology, Dr Rajendra Prasad Government Medical College Kangra at Tanda. Himachal Pradesh. India