Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.

INTRODUCTIONThird stage of labour begins after the delivery of the fetus till the expulsion of the placenta and membranes. 1 Though the third stage constitutes short span of time, it is the phase of maximum maternal mortality and morbidity.One of the major hazards being post partum haemorrhage. PPH complicates approximately 4% of vaginal deliveries and 6% of caesarean deliveries. WHO statistics suggest 30% of maternal deaths worldwide with an estimated 1.25 million cases and morbidity in 20 million women annually are due to PPH. 2,3Uterine atony is the most common cause constituting about 80-90% of cases.4 So, we have to aim at increasing the tone of the uterus by using uterotonic drugs to reduce PPH. Various uterotonic drugs is available like Oxytocin, Ergometrine, Prostaglandins.5 To prevent and treat PPH, literature strongly suggests the use of active management of 3rd stage 6 which includes use of Oxytocin at the time of delivery of anterior shoulder, controlled cord traction, ABSTRACT Background: Post partum haemorrhage is the most common cause of maternal morbidity and mortality. Misoprostol is a prostaglandin analogue, used for management of post partum haemorrhage. It can be used by various routes with minimal side effects. This study is done to compare the different routes of administration of Misoprostol for the third stage management and their side effects. Objectives of present study were to estimate the amount of blood loss, to assess the maternal side effects of drug, to know the haemoglobin deficit, to know the duration of third stage of labour. Methods: This was a prospective hospital base study of 150 women delivery at obstetrics and gynaecology department at ESICMC Model Hospital, Rajajinagar. They were randomized into 3 groups of 50 patients each. They received 400 µg of misoprostol either orally or rectally or sublingually immediately after delivery of the fetus. The primary outcomes analysed were amount of blood loss duration of third stage of labour haemoglobin deficit and their side effects Results: The amount of blood loss and haemoglobin deficit was least in sublingual group which was statistically significant. Need of additional oxytocics was less in sublingual and oral group, though it was not statistically significant. Conclusions: In the present study, sublingual Misoprostol was found to be more effective in reducing blood loss during third stage of labour.

Thyroid disorders are the second most common cause of endocrine dysfunction in women of child bearing age after diabetes mellitus. It is now well established that not only overt, but also subclinical thyroid dysfunction have significant adverse effects on pregnancy and fetal development. The adverse pregnancy outcomes include, miscarriage, pregnancy induced hypertension, and its more severe form pre-eclampsia, as well as placental abruption, anaemia, post partum hemorrhage, and increased fetal morbidity and mortality. Thyroid testing is a must at first booking. Adequate replacement therapy should be done to keep TSH with in trimester specific referrence ranges. Early and effective treatment of thyroid disorders ensures safe pregnancy with minimal maternal and fetal complication.