1Senior Resident, Dept of Obstetrics and Gynaecology, SKIMS Medical College Hospital, Bemina, Jammu & Kashmir
2Assistant Professor, Department of OBG, Sree Siddhartha Medical College, Tumkur, Karnataka
3HOD, Department of OBG, Bhagwan Mahaveer Jain Hospital, Bangalore, Karnataka
4Consultant, Department of OBG, Bhagwan Mahaveer Jain Hospital, Bangalore, Karnataka
*Address for Correspondence: Dr Muzamil Shafi Senior Resident, Dept of Obstetrics and Gynaecology, SKIMS Medical College Hospital, Bemina, Jammu & Kashmir, Mobile No: +919419069702, +919448820554, E mail: Muzamil_sh1@yahoo.com, Muzamilsh1@gmail.com
Online published on 24 August, 2016.
Thyroid dysfunction in pregnancy is associated with increased incidence of both maternal and fetal complications. High risk screening might leave about one third of pregnant women with thyroid dysfunction undiagnosed and untreated. Population screening helps in detection of thyroid dysfunction and timely treatment might improve obstetric outcome. With this background, this study aims to screen pregnant women of thyroid dysfunction using a simple test like TSH and evaluate relationship between abnormal TSH and pregnancy outcome in Indian population.
200 pregnant women were registered after oral consent for the study. Serum TSH level was estimated and interpreted using trimester specific reference ranges. Abnormal TSH was further evaluated by free T4 and thyroidperoxidase antibody level estimation. Treatment was started and screened population was followed till delivery. Both obstetrical and perinatal outcomes were noted.
Incidence of thyroid dysfunction was high (12%) in this study with subclinical hypothyroidism in 9.5%, overt hypothyroidism in 2% and subclinical hyperthyroidism in 0.5% women. 41.7% screen positive women did not have risk factors for thyroid disease. These could have been missed if targeted high risk screening was adopted. The overall incidence of complications in screen positive (hypothyroid) women was 65.2% as compared to 25.6% in screen negative population (p < 0.001**). More than 50% of the women had more than one adverse outcome. The occurrence of complications was significantly associated with overt hypothyroidism (75%) with P value 0.0270*. Subclinical hypothyroidism was also strongly associated with presence of complications (63.2%) with P value <0.001**.
Serum TSH estimation is a simple, reliable and highly sensitive screening tool for detecting thyroid dysfunction during pregnancy. Routine screening for thyroid disorders in pregnancy might improve both maternal and fetal outcome.
Thyroid dysfunction, TSH, Screening, Pregnancy
