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Prevalence of thyroid dysfunction in pregnancy and its implications

Alpana Singh, Mary Jayasheela Reddy.

Abstract
Background: Thyroid disorders are one of the most common endocrine disorders in pregnancy. Thyroid disorders are known to be associated with abnormal maternal and fetal outcomes and are often overlooked in pregnant women because of nonspecific symptoms and hypermetabolic state of pregnancy.

Objective: To determine the prevalence of thyroid dysfunction and study its implications in pregnancy in a tertiary-care hospital.

Materials and Methods: Four hundred pregnant women in the first trimester from November 2013 to October 2014 were recruited for the study. Serum thyroid-stimulating hormone (TSH) test was done, apart from the routine blood sample investigations as per FOGSI-ICOG Good Clinical Practise Recommendations. Free T4, free T3, and thyroid peroxidase antibody tests were done in patients with a deranged TSH value. Patients were followed up till delivery, and obstetrical complications arising out of thyroid dysfunction were noted and managed.

Result: The prevalence of hypothyroidism was 7.5% and hyperthyroidism 0.75%. When compared with patients with euthyroidism, preeclampsia and intrauterine growth restriction were the most significant complications observed in patients with hypothyroidism, with the incidence of 33.3% versus 7.3% and 16.6% versus 5.7%, respectively. Incidence of cesarean section was documented to be high in hypothyroidism (39.28% vs. 23.3%), and 36.36% of those were performed to avoid fetal distress.

Conclusion: Prevalence of hypothyroidism was found to be high in our study and was associated with adverse pregnancy outcomes; hence, antenatal thyroid screening should be judiciously offered. Routine testing with serum TSH is a sufficient and cost-effective screening tool.

Key words: Thyroid dysfunction, miscarriage, anemia, preeclampsia, preterm labor, intrauterine growth retardation



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