Authors : Rohini N. S, Ravishankar S. N, Madhuvan H. S, Sudha Patil, Rakshith N. R
DOI : 10.18231/2394-2754.2018.0055
Volume : 5
Issue : 2
Year : 0
Page No : 247-252
Aims and Objectives: The study was undertaken in pregnant women to understand and analyze the obstetric and fetal outcomes of thyroid disorders.
Materials and Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5mIU/ml in first trimester and above 3mIU/ml in second and third trimesters were evaluated for freeT3, freeT4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.
Results: Total no of pregnant women screened were 860, of which 130 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 15.11%. Of the 130 patients with thyroid disorders, 126 were hypothyroid and 4 were hyperthyroid. Among the 126 hypothyroid cases, 48 were known cases and 78 were new cases. The total cases of subclinical hypothyroidism were 91, prevalence being 10.58% and overt cases were 35, prevalence being 4.06%; 4 cases were overt hyperthyroid, prevalence being 0.4%. 60.3% of subclinical hypothyroidism were TPO positive and 39.6% of overt hypothyroidism were TPO positive (p value-<0.05). Out of 130 abnormal thyroid function patients, 98 patients delivered in our hospital. There were 16 abortions, 14 spontaneous and 2 terminations of pregnancies; 6 patients were lost for follow up, 7 patients have delivered outside and 1 patient lost follow up.
Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest.
Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and fetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients.
Keywords: Sub-clinical hypothyroidism, Overt hypothyroidism, Thyro peroxidase antibody (TPO Abs), Hyperthyroidism, preterm abortions, IUGR, Eclampsia.