Analysis of Feto-Maternal Outcome in Patients with Hypothyroidism in Pregnancy
Journal Title: Scholars Academic Journal of Biosciences - Year 2017, Vol 5, Issue 10
Abstract
Thyroid disorders are the second most common endocrinological disorders in pregnancy next to diabetes mellitus. Despite all the evidence available regarding the adverse feto-maternal outcome in women with thyroid dysfunction, universal screening for thyroid dysfunction is not accepted by all the authorities. The current study is designed to study the prevalence and feto-maternal outcome in women with hypothyroidism in a tertiary care centre catering population from 7 North-East Indian states and compare it with other regions of India. 100 pregnant women with hypothyroidism were followed up through-out pregnancy and their feto-maternal outcomes were compared with 100 euthyroid women. The maternal outcomes studied were: ante-partum factors (anemia, pre-eclampsia, abortions, IUGR, IUFD), Intra-partum events (progress of labor, liquor stain during labor, mode of delivery and indication of instrumental/operative delivery) and post-partum complications. Neonatal outcomes studied were birth weight, Apgar score(1’,5’), NICU admission, jaundice requiring treatment, respiratory distress, sepsis, hypoglycemia, hypothermia, and early neonatal death.The prevalence of hypothyroidism in this study was 6.0%. (SCH- 4.21%, OH- 1.79%) Comparison of pre-term labor with hypothyroidism shows statistical significance (p valu- 0.01). Hypertensive disorder of pregnancy was significantly higher among cases than controls(p value-0.02). Higher incidence of low birth-weight babies among cases than controls(32.5% vs. 15.5%) can be attributed to prematurity. We emphasize on universal screening of hypothyroidism in pregnancy and categorizing them as high risk pregnancy. With early diagnosis and prompt treatment of this condition feto-maternal outcome can be improved. Follow-up with S.TSH levels every 4 weeks through-out pregnancy is also mandatory to keep up the feto-maternal outcome.
Authors and Affiliations
Dr. Roma Jethani, PGT, Dr. Ananya Das, Dr. Subrat Panda, Dr. Himesh Barman, Dr. Alice Ruram, Prof. A. Santa Singh
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