Prevalence of hypothyroidism in pregnancy

Abstract

Introduction: Pregnancy is a period that places great physiological stress on both the mother and the fetus. 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. When pregnancy is compounded by endocrine disorders such as hypothyroidism, the potential for maternal and fetal adverse outcomes can be immense. Methods: The present study was conducted at KIMS hospital, Narketpally. It is a prospective type of study which includes 48 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimester. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels were estimated. Prevalence of hypothyroidism was noted. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted. Results: In the present study, 48 out of 700 pregnant women screened had thyroid disorders. The prevalence of Hypothyroidism in this study is 6.8%.In the present study, it is affecting more in the age group of 21 to 30 yrs in multigravida, the prevalence of subclinical hypothyroidism is 6.1% and overt hypothyroidism is 0.7% .86% of pregnancies with SCH had cesarean section, fetal distress (48.38%) being the most common indication. The perinatal mortality rate in hypothyroid women was found out to be 5.5%. Conclusion: Routine screening, early confirmation of diagnosis and prompt treatment is required to ensure favorable maternal and fetal outcomes. Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes. It is difficult to diagnose hypothyroidism clinically in pregnancy due to non specific presenting features which may be masked by existing obstetric symptoms. While targeted case finding is generally practiced, recent evidence seems to indicate that universal screening might be a better option.