Effects of hypothyroidism on maternal and foetal outcome

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Effects of hypothyroidism on maternal and foetal outcome

Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2

Abstract

Hypothyroidism in pregnancy is associated with significant Obstetrical and Neonatal complications, which leads to increased maternal morbidity, perinatal morbidity and mortality. Material and Methods: This retrospective study was conducted from June 2014 to June 2015 to determine the current prevalence of thyroid dysfunction among pregnant women and its impact on maternal and foetal outcome in Obstetrics and Gynaecology Department, Krishna Institute of Medical Sciences, Karad. Total cases studied were 4573. Out of 4573 cases 43 (0.94%) cases were diagnosed having hypothyroidism. Data collected from all these diagnosed cases of hypothyroidism regarding last thyroid profile values, dose of thyroxin, associated significant medical or surgical illness, frequency of ANC, antenatal, intrapartum maternal complications such as PIH, oligohydramnios, anaemia, preterm delivery, IUGR, mode of delivery and foetal complications in terms of period of gestation at delivery, birth weight of babies, need for NICU for these babies. All these hypothyroid patients further divided in subclinical hypothyroidism as Group A and overt hypothyroidism as Group B. Results: Among 43 hypothyroid cases, there were 30 (69.77%) patients in group A and 13 (30.23%) patients in group B. Group A has more incidences of patients who; conceived after treatment for infertility, IUGR, Polyhydramnios, oligohydramnios, anaemia in antenatal period compared to group B (8vs 5,2 vs 1, 2 vs 0, 1vs 0, 1 vs 0 respectively). There was 1 case of history of bad obstetric history and 1 case of IUD in group B. Some of these were having combined complications also. Out of total 43 cases of Hypothyroidism, 35% patients delivered by normal vaginal delivery and 35% patients underwent LSCS in group A. Where else 14% patients delivered by normal vaginal delivery and 16% patients underwent LSCS in group B. The various indications for lower segment caesarean section were infertility, uteroplacental insufficiency, IUGR, severe preeclampsia, non-reassuring NST and foetal distress.19% babies from group A and 9% babies from group B were having birth weight <2.5 kg. There were 51% babies from group A and 21%babies from group B having birth weight >2.5 kg. The two-sided P value is 0.7830, considered not significant. Chi-square = 0/0759 and Odds ratio =0.8182.56% babies from group A and 21% babies from group B were born with good outcome and stable after delivery. Whereas 16% babies from group A and 5% babies from group B required NICU admission for causes like birth asphyxia, low birth weight. There was 1 (2%) baby IUD in group B. Conclusion: As use of TSH for diagnosis of thyroid dysfunction is widely reproducible, reliable and not expensive, it is an important tool to diagnose hypothyroidism especially in this modern era, where each baby is precious due to small family norms, increasing age of motherhood. Present study concluded that incidence of antennal complications such as PIH, anaemia, preterm delivery, incidence of LSCS, low birth weight, need for NICU is more in subclinical hypothyroidism compared to overt hypothyroidism. We also concludes that in spite of great discrepancies in recommendations on universal screening of hypothyroid dysfunction in pregnancy, high prevalence of hypothyroidism in our country and its great impact on maternal and foetal health makes it necessary to screen all the pregnant women early gestation as per Indian Thyroid Society guidelines.

Authors and Affiliations

Gauri Raghunath Shinde, Dipa R Vaghasia, Manisha Laddad

Keywords

EP ID EP498672
DOI -
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