Aim To determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome. Methods 400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted. Results The prevalence of hypothyroidism and hyperthyroidism was 12 and 1.25 %, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8 %) and placental abruption (16.6 vs. 0.8 %). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8 %) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (16.6 vs. 2.39 %), preterm birth (33.3 vs. 5.8 %), low birth weight (50 vs. 12.11 %), intrauterine growth retardation (25 vs. 4.9 %), and fetal death (16.6 vs. 1.7 %) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39 %), preterm delivery (11.2 vs. 5.8 %), low birth weight (25 vs. 12.11 %), and intrauterine growth retardation (8.4 vs. 4.9 %) as compared to the euthyroid women. Conclusions The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.
A balanced approach to EOH can prove to be lifesaving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of cesarean section and multiple pregnancies particularly in urban settings in developing countries.
Thyroid dysfunction is an important causative etiology of menstrual abnormalities. Assessment of thyroid function should be done in all patients with menstrual disorders to avoid unnecessary interventions like curettage and hysterectomy.
Aim To assess the prevalence of vitamin D deficiency in burka-clad pregnant women and to study feto-maternal outcome in these women. Methods 200 pregnant burka-clad women of 18-40-year age group irrespective of the period of gestation were recruited from the ANC OPD/ward of Kasturba hospital, and their vitamin D levels were estimated. Patients were categorized into vitamin D deficient, vitamin D inadequate, and vitamin D adequate according to The Endocrine Society Guidelines. The association of vitamin D deficiency with dietary/environmental factors was taken note of. Associations with preeclampsia, gestational diabetes mellitus (GDM), low birth weight (LBW), prematurity, APGAR score, and NICU admission were also studied. Results 78 patients (39.0 %) were vitamin D inadequate; 75 patients (37.5 %) were vitamin D deficient; and 47(23.5 %) were vitamin D adequate. Mean value of vitamin D level was 23.25 ng/ml ± 18.49 (SD). Fifteen patients (7.5 %) developed preeclampsia, and all 15 were vitamin D deficient; 13 (6.5 %) developed GDM; and only 5 (2.5 %) of them were vitamin D deficient. 19 patients (9.5 %) delivered LBW babies; mothers of 15 (7.5 %) of them were vitamin D deficient. 12 patients (6.0 %) 123 delivered premature babies, and mothers of 4 (2 %) were vitamin D deficient; 12 babies had APGAR score \7 at 5 min; mothers of 4 (2.0 %) were vitamin D deficient. Babies of 12 patients (6 %) were admitted in NICU, and of these 12 babies, mothers of 5 (2.5 %) were vitamin D deficient. Conclusion The prevalence of vitamin D deficiency was high among burka-clad pregnant women, and it is associated with adverse maternal and fetal outcomes. Routine screening of vitamin D levels is recommended in burkaclad women to improve the feto-maternal outcome.
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