DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182047

Hypothyroidism in pregnancy: the scourge of the hills

Rony Chakravarty, Varun Bajaj, Rajesh Nair, Ramkumar Gupta, Pankaj P. Rao

Abstract


Background: Hypothyroidism is a causal agent sub serving a multitude of complications in pregnancy. There is a lot of controversy regarding universal screening for thyroid abnormalities during pregnancy. An attempt was made to ascertain the incidence of hypothyroidism during pregnancy in a peripheral hospital.

Methods: All patients reporting to ANC OPD were subjected to thyroid profile and results tabulated as per ATA guidelines 2017. Patients with clinical hypothyroidism were followed up with treatment to look for condition related complications if any. Complications despite treatment were noted and included only after ruling out masquerading mimickers or co existent conditions.

Results: An incidence of 14.46% per two years was detected with hypothyroidism.

Conclusions: The need for universal screening for hypothyroidism is inescapable particularly in hilly terrain.


Keywords


Free T4, Hypothyroidism, Pregnancy Complications, Thyroid Stimulating Hormone (TSH)

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References


Bagcchi S. Hypothyroidism in India: more to be done. Diabetes and endocrinology. Lancet. 2014;2:778-1.

Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017;27:315-89.

Blumenthal NJ, Eastman CJ. Beneficial effects on pregnancy outcomes of thyroid hormone replacement for subclinical hypothyroidism. J Thyroid Res. 2017.

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

Gahlawat P, Singh A, Nanda S, Kharb S. Thyroid dysfunction in early pregnancy and spontaneous abortion. Biomedical Biotechnol Res J. 2017;1:81.

Chen S, Zhou X, Zhu H, Yang H, Gong F, Wang L,. Preconception TSH and pregnancy outcomes: a populationā€based cohort study in 184 611 women. Clin Endocrinol. 2017;86:816-24.

Morchiladze N, Tkeshelashvili B, Gagua T, Gagua D. Prognostic risk of obstetric and perinatal complications in pregnant women with thyroid dysfunction. Georgian Medical News. 2017;264:21-5.

Sahu M, DaS S, PaniGrahi PK, NANDA S. A Prospective Study of Routine Screening of Hypothyroidism in Antenatal Patients and their Outcome with Levothyroxine Treatment. J Clini Diagnos Res. 2017;11(10).

Kilpatrick SJ. ACOG Practice Bulletin Number 148: thyroid disease in pregnancy. Obstet Gynecol. 2015; 125:996-1005.

Ahad F, Ganie A. Iodine, Iodine metabolism and Iodine deficiency disorders revisited. Indian J Endocrinol Metab. 2010;14:13-17.

Dhanwal D, Bajaj S. Prevalence of hypothyroidism in pregnancy: An epidemiological study from 11 cities in 9 states of India. Indian J Endocrinol Metab. 2016;20;387-90.

Ahmed M, Zama YS. Iodine deficiency in children: A comparative study in two districts of south-interior Karnataka, India. J Family Community Med. 2014;21:48-52.

Yang H, Shao M, Chen L, Chen Q, Yu L, et al. Screening strategies for thyroid disorders in the first and second trimester of pregnancy in China. PLOS ONE. 2014;9:e99611

National Guidelines for Screening of Hypothyroidism during Pregnancy. Ministry of Health and Family welfare, India. 2014:4-5.