Sathyavani, S (2021) A Comparative study between Maternal and Fetal Outcome of Hypothyroid Pregnant Women with Normal Pregnancy Women. Masters thesis, (2018-2019) Thanjavur Medical College, Thanjavur.
Full text not available from this repository.Abstract
INTRODUCTION: Thyroid disorders are the 2nd most common endocrine disorders, its also encountered in pregnancy and reproductive life of a woman. During normal pregnancy, thyroid physiology is modified, Throughout the gestation these changes takes place. These changes helps maternal thyroid gland to adapt metabolic demand of pregnancy, and all these changes are reversible in post partum. Maternal complications of clinical hypothyroidism are abortions, preeclampsia, anemia, placental abruption and post partum hemorrhage. Foetal complication are premature birth, low birth weight, IUGR, increased neonatal respiratory distress, congenital hypothyroidism and impaired cognitive function. OBJECTIVE OF THE STUDY: 1. PRIMARY OBJECTIVE: To study the perinatal outcome of hypothyroid pregnant woman with normal pregnant woman and its maternal and fetal complications. 2. SECONDARY OBJECTIVE: To determine the thyroid function test should recommended as a universal screening (or) high risk screening for the pregnant mothers. In pregnancy due to excessive thyroid demand causes increase in thyroid size by 10% in iodine sufficient areas. In Iodine deficient areas thyroid function test are elevated by 20-40%. In the first half of the pregnancy, increased in the production of thyroid hormones both T3 and T4 by 50%, it associated with 50% increase women daily iodine requirement. It reaches a plateau at 20 weeks of pregnancy. TRIMESTER: 1st trimester - VALUE: 0.1-2.5mIU/l, 2nd trimester - 0.2-3mIU/l and 3rd trimester - 0.3-3mIU/l. MATERIALS AND METHODS: STUDY DESIGN: A Comparative clinical prospective study with 100 pregnant women with hypothyroidism and 100 normal pregnant women is undertaken to study the maternal and fetal complications. SAMPLE SIZE: 200 patients with 100 cases and 100 controls. INCLUSION CRITERIA: 1. Singleton Pregnancy. 2. Primigravida and multi gravida belonging to any age. 3. Patients in first and second trimester. 4. Patient previously diagnosed and on treatment is also included in the study. EXCLUSION CRITERIA: 1. Multiple pregnancies. 2. Any antenatal and medical complications other than hypothyroidism. METHODS OF COLLECTION: All women with singleton pregnancy in first and second trimester, who came to OBG OPD and for admission at Rajamirasudar Government Hospital Thanjavur Medical College, between January 2019 and December 2019 (1year) were be administered a TSH test at first visit. DISCUSSION: In the present study 35% of cases gave a history of abortion in the previous pregnancy. Pratt et al (1993) found a 31% of risk of abortion among hypothyroid mothers. Similar reports were also seen in studies done by Sharma partha [59] et al and Lueng [60] et al and the results were comparable. Most common maternal complication is Anemia. In this study Anemia is seen in 50% cases as compared to 31% controls and statistically significant (P 0.005). PIH is another frequent complication. Its noted in 28% cases and 15/controls (P0.003). preterm labour is seen in 22% cases and 15% controls (P0.003) Davis et al (47) in 1988 in a study of hypothyroidism complicating pregnancy, found that maternal complications are more common in hypothyroid women with an increase in Anemia (31%) and preeclampsia 44% in them. In this study other complications like still birth, intra uterine death (4% cases Vs 1% control P 0.027), abruption (2% cases Vs 0% control) P 0.027), premature rupture of membrane (6% cases Vs 4% control P 0.027) and preterm labor (22 %cases Vs 15 control P0.003) this might be explained as almost all of these women were treated once diagnosed hence showing that treatment improves out comes. CONCLUSION: The study concludes that hypothyroidism in pregnancy is significantly associated with maternal complications like abortions anemia, pregnancy induced hypertension and preterm labor. Higher caesarean rates were also observed among hypothyroid mothers. Even though good Apgar scores there is increased NICU admissions, low birth weight mainly due to prematurity are usually noted in the neonate. Early initiation of treatment and maintenance of a normal level of thyroid hormones significantly minimizes the risk of maternal and fetal complications and makes it possible that the pregnancy may be carried to term without severe complications. PIH and anemia inspite of treatment showed an increased incidence among cases.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221816210 |
| Uncontrolled Keywords: | Anti PPO antibodies, pregnancy, abruption, PIH, anemia. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 15 May 2021 12:58 |
| Last Modified: | 03 Oct 2021 15:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/16736 |
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