Prevalance and fetomaternal outcome of thyroid disorder in pregnanacy
Rajita S Jani, Devangi S Munshi, Shashwat K Jani, Sanjay P Munshi, Smit B Solanki, Viral M Pandya.
Background: Thyroid diseases are the commonest endocrine disorders affecting women of reproductive age group and hence constitute the commonest endocrine disorder in pregnancy also. It has long been recognized that maternal thyroid hormone excess or deficiency can influence the outcome for mother and fetus at all stages of pregnancy as well as interfere with ovulation and fertility. Thyroid dysfunction is often overlooked in pregnant women because of the nonspecific symptoms and the hyper metabolic state of pregnancy. Hence thyroid function test becomes essential to know the thyroid status in pregnancy and also to detect the subclinical disease.
Aims & Objective: To establish the prevalence and effect of thyroid disorder on pregnancy outcome.
Materials and Methods: The study is an observational study carried on 100 women coming for antenatal check-up in Private hospital, Ahmedabad from January 2011 to January 2012. All women who were included in this study were followed from 11-14 weeks of pregnancy up to delivery.
Results: It was observed that the maximum numbers of patients were in 21 25 years (52%) age group. Euthyroid (87%), hyperthyroid (1%), subclinical hyperthyroid (2%), hypothyroid (2%), and subclinical hypothyroid (8%) cases were detected. Neonatal jaundice developed in all Hyperthyroid patient, 50% (1/2) of patients with Subclinical hyperthyroidism, 50% (1/2) of patients with Hypothyroidism, 75% (6/8) of patients with Subclinical Hypothyroidism and 48.27% (42/87) of patients with Euthyroid.
Conclusion: Gestational age specific reference intervals are of utmost importance by which clinicians can reliably evaluate thyroid function and monitor thyroxine replacement therapy in pregnant women. TPOAb (Thyroid peroxidase Antibody) positive patients are associated with an increased risk of abortion and these infants are more often born preterm. TSH is the hallmark in detection of hypothyroid as well hyperthyroid so TSH should be included in the list of routine investigations done in all antenatal women in first trimester. If TSH values are abnormal then FT3, FT4 and TPOAb need to be checked.
Key words: Thyroid Disease; Pregnancy; Feto-Maternal Outcome; Prevalence