A descriptive study of the prevalence of hypothyroidism among antenatal women and foetal outcome in treated hypothyroid women

Authors

  • Divya R. Prasad Department of Obstetrics and Gynecology, Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India
  • Neelima V. Nair Department of Obstetrics and Gynecology, Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India
  • Deepika K. Department of Obstetrics and Gynecology, Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20161685

Abstract

Background:The objective of the study was to find out the prevalence of hypothyroidism among pregnant women and to study the foetal outcome in antenatal mothers in whom treatment was initiated early in pregnancy.

Methods:This was a descriptive study conducted in the department of OBG Sree Gokulam Medical College, Venjaramoodu, Trivandrum from April 2013 to Oct 2014. 500 antenatal women coming for routine antenatal check up in the first trimester to antenatal OP were screened for hypothyroidism.TSH(thyroid stimulating hormone) was done in the first trimester and the prevalence of hypothyroidism was estimated. Patients were diagnosed as having subclinical or overt hypothyroidism based on the FT3 (free T3) and FT4 (free T4) results. Patients detected with hypothyroidism –both subclinical and overt were started on appropriate dose of L-thyroxin depending on her gestational age, body weight and level of TSH. Every 6weeks TSH levels were estimated and the dose of the drug adjusted. All these patients were followed up for their foetal outcome such as intrauterine demise, hyperbilirubinemia, prematurity, stillbirths and neonatal hypothyroidism.

Results: In the present study, the prevalence of hypothyroidism was 5.6% of which 4% were having subclinical and 1.6% was having overt hypothyroidism. No significant difference in foetal complications, perinatal mortality and morbidity was noted between hypothyroid and euthyroid women.

Conclusions:TSH testing should be included in routine antenatal investigations for early detection of subclinical and overt hypothyroidism among antenatal women and early treatment should be initiated so as to prevent complications.

1.       Akhter SN, Tarannum R, Kabir MS. Pregnancy in overt and subclinical hypothyroidism and its fetomaternal outcome. Med Today. 2014;25(2).

2.       Sahu MT, Das V, Mittal S, Aggarwal A, Sahu M. overt and subclinical hypothyroid dysfunction among Indian pregnant women and its effect on maternal and foetal outcome. Arch Gynecol Obstet. 2010;281(2):215-20.

3.       Ajmani SN, Aggarwal D, Bhatia P, Sharma M, Sarabhai V, Paul M. Prevalence of overt and subclinical thyroid dysfunction among pregnant women and its effect on maternal and foetal outcome. J Obstet Gynecol India. 2014;64(2):105-10.

4.       Nirmala CV. Maternal outcome of hypothyroidism in pregnancy- a south Indian perspective. Am J Clin Med Res. 2014;2(2):47-50.

5.       Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A. Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci. 2005;59 (3):116-7.

6.       Cleary-Goldman J, Malone FD, Lambert-Messerlain G, Sullivan L, Canick J, Porter TF, et al. Maternal thyroid hypo function and pregnancy outcome. Obstet Gynecol. 2008;112(1):85-92.

7.       Casey BM, Dashe JS, Wells CE, McIntre DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239-45.

8.       Allan WC, Haddow JE, Palomaki GE, Williams J R, Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications implications for population screening. J Med Screen. 2000;7(3):127-30.

9.       Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid Off J Am Thyroid Association. 2011;21(10):1081-125.

10.   

Cite this article as: Prasad DR, Nair NV, Deepika K.A descriptive study of the prevalence of hypothyroidism among antenatal women and foetal outcome in treated hypothyroid women.Int J Reprod Contracept Obstet Gynecol 2016;5:1892-6.

Basnet P, Aggarwal N, Suri V, Dutta P, Mukhopadhyay K. Comparison of Maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed before conception with hypothyroidism diagnosed during pregnancy Univers Coll Med Sci. 2014;2(2).

References

Akhter SN, Tarannum R, Kabir MS. Pregnancy in overt and subclinical hypothyroidism and its fetomaternal outcome. Med Today. 2014;25(2).

Sahu MT, Das V, Mittal S, Aggarwal A, Sahu M. overt and subclinical hypothyroid dysfunction among Indian pregnant women and its effect on maternal and foetal outcome. Arch Gynecol Obstet. 2010;281(2):215-20.

Ajmani SN, Aggarwal D, Bhatia P, Sharma M, Sarabhai V, Paul M. Prevalence of overt and subclinical thyroid dysfunction among pregnant women and its effect on maternal and foetal outcome. J Obstet Gynecol India. 2014;64(2):105-10.

Nirmala CV. Maternal outcome of hypothyroidism in pregnancy- a south Indian perspective. Am J Clin Med Res. 2014;2(2):47-50.

Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A. Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci. 2005;59 (3):116-7.

Cleary-Goldman J, Malone FD, Lambert-Messerlain G, Sullivan L, Canick J, Porter TF, et al. Maternal thyroid hypo function and pregnancy outcome. Obstet Gynecol. 2008;112(1):85-92.

Casey BM, Dashe JS, Wells CE, McIntre DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239-45.

Allan WC, Haddow JE, Palomaki GE, Williams J R, Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications implications for population screening. J Med Screen. 2000;7(3):127-30.

Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid Off J Am Thyroid Association. 2011;21(10):1081-125.

Basnet P, Aggarwal N, Suri V, Dutta P, Mukhopadhyay K. Comparison of Maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed before conception with hypothyroidism diagnosed during pregnancy Univers Coll Med Sci. 2014;2(2).

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Published

2017-01-05

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Original Research Articles