A prospective clinical study of pregnancy with hypothyroidism and it's outcome in a tertiary care hospital

Abstract

Introduction: Pregnancy is a period that places great physiological stress on both the mother and the fetus. If pregnancy at any stage is complicated by some endocrine disorder such as hypothyroidism, the new born may have profound effect on future intellectual development. The growing fetus remains dependent on maternal thyroid hormone in early phase of gestation because the fetal thyroid gland starts functioning at 12 to 14 weeks of gestation. There is significant increase in the size of thyroid gland during pregnancy which is approximately 10% in iodine sufficient countries and to a greater extent in countries where there is deficiency of iodine.Materials and Methods: Present study has been conducted in the Department of Obstetrics and Gynecology, Govt Medical College, Ananthapur, Andhra Pradesh, India. This is a prospective observational study. All pregnant women attending antenatal outpatient department for their first antenatal check-up were approached and in addition to routine lab investigation thyroid function test was advised. Out of them patients were selected based on following inclusion and exclusion criteria.Results: In present study during study period 500 patients attending obstetrics outpatient department were evaluated for hypothyroidism out of them 60 patients with hypothyroidism were enrolled for this study. Clinical and demographic profile of patients 11.6 patients were below 20 year of age, 23.33% patients were between 21 to 30 years of age, 41.17% patients were between 31 to 40 years of age and 23.33% of patients were above 41 year of age. In this study 78.33% patients were below 10 weeks of gestation and 21.66% were above 10 weeks of gestation. Regarding gravidity of patients 63.33 % patients were primi and 36.66% patients were multi. Serum TSH was between 3 to 5 mIU/ml in 13.33 % patients, 5 to 10 mIU/ml in 60% and more than 10 mIU/ml in 26.66% patients. At the time of admission 58.33% patient were taking treatment and 41.66 % patient were not treated.Conclusion: From our study we can conclude that the prevalence of hypothyroidism in our region was 12%. Hypothyroidism during pregnancy is more common in primi. Most common age group was third decade and was commonly detected before 10 weeks of gestation. Pregnancy induced hypertension, oligohydramnios and preterm delivery was more common than abortion in second trimester and missed abortion. Normal vaginal delivery was common then elective or emergency CS.