Disorders In Pregnant Women Research Articles

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Background: Inherited red blood cell disorders are prevalent in populations living in malaria endemic areas; G6PD deficiency is associated with oxidant-induced hemolysis and abnormal hemoglobin variants may cause chronic anemia. In pregnant women, microcytic anemia caused by hemoglobinopathies mimics iron deficiency, complicating diagnosis and treatment. Anemia during pregnancy is associated with morbidity and mortality. The aim of this study was to characterize the prevalence of G6PD deficiency, hemoglobinopathies, ABO and Rhesus blood groups among the pregnant population living along the Thailand-Myanmar border. Pregnant women attending antenatal clinics in this area belong to several distinct ethnic groups. Methods: Data was available for 13,520 women attending antenatal care between July 2012 and September 2016. Screening for G6PD deficiency was done by fluorescent spot test routinely. G6PD genotyping and quantitative phenotyping by spectrophotometry were analyzed in a subsample of women. Hemoglobin variants were diagnosed by HPLC or capillary electrophoresis and molecular methods. Blood groups were diagnosed by agglutination test. The prevalence and distribution of inherited red blood cell disorders and blood groups was analyzed with respect to ethnicity. Results: G6PD deficiency was common, especially in the Sgaw Karen ethnic group, in whom the G6PD Mahidol variant allele frequency was 20.7%. Quantitative G6PD phenotyping showed that 60.5% of heterozygote women have an intermediate enzymatic activity between 30% and 70% of the population median. HbE, beta-thalassemia trait and alpha-thalassemia trait were found in 31.2% of women. Only 0.15% of women were Rhesus negative. Conclusions: Distribution of G6PD and hemoglobin variants varied among the different ethnic groups, but the prevalence was generally high throughout the cohort. These findings encourage the implementation of an extended program of information and genetic counseling to women of reproductive age and will help inform future studies and current clinical management of anemia in the pregnant population in this region.

Lack of Association Between Cytomegalovirus Infection and Hypertensive Disorders in Pregnancy: A Case-Control Study in Durango, Mexico.

It is not clear whether infection with cytomegalovirus (CMV) is associated with hypertensive disorders in pregnant women. Through a case-control study design, 146 women suffering from hypertensive disorders in pregnancy (cases) and 146 age-matched normotensive pregnant women (controls) were examined for the presence of anti-CMV IgG and IgM antibodies with enzyme-linked immunoassays. IgM seropositive samples were further assayed by enzyme-linked fluorescent assay (ELFA).Anti-CMV IgG antibodies were found in 138 (94.5%) controls and in 136 (93.2%) cases (odds ratio [OR] = 0.78; 95% confidence interval [CI]: 0.30–2.05; P = 0.62). High (>18 IU/ml) levels of anti-CMV IgG antibodies were found in 37.7% of the 138 seropositive controls and in 34.6% of the 136 seropositive cases (OR = 0.87; 95% CI: 0.53–1.43; P = 0.59). Anti-CMV IgM antibodies were found in 1 (0.7%) of the controls but in none of the cases using ELFA (P = 1.0). Seropositivity to CMV was not associated with a previous preeclampsia and was similar among cases regardless their mean systolic and diastolic blood pressures, and mean arterial blood pressure.No serological evidence of an association between CMV infection and hypertensive disorders of pregnancy was found. Further research to elucidate the role of CMV in hypertensive disorders in pregnancy should be conducted.

Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women.

Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed. Outside of pregnancy, buprenorphine is used in combination with naloxone to reduce opioid abuse and diversion. During pregnancy, however, the use of buprenorphine as a single agent is preferred to prevent prenatal naloxone exposure. Both methadone and buprenorphine are widely used to treat opioid use disorder; however, compared with methadone, buprenorphine is associated with shorter treatment duration, less medication needed to treat neonatal abstinence syndrome (NAS) symptoms, and shorter hospitalizations for neonates. Despite being the standard of care, medication-assisted treatment with methadone or buprenorphine is still underused, making it apparent that more options are necessary. Naltrexone is not a first-line treatment primarily because both detoxification and an opioid-free period are required. More research is needed to determine naltrexone safety and benefits in pregnant women. Animal studies suggest that changes in pain sensitivity, developmental processes, and behavioral responses may occur in children born to mothers receiving methadone, buprenorphine, or naltrexone and is an area that warrants future studies.

Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina.

Background Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population.

Polyunsaturated fatty acids and inflammatory markers in major depressive episodes during pregnancy

IntroductionPrenatal depression (PND) is a common psychiatric disorder in pregnant women and leads to psychosocial dysfunction, high suicidal rate, and adverse childcare. Patients with PND have omega-3 polyunsaturated fatty acid (omega-3 or n-3 PUFAs) deficits, which might link to chronic low-grade inflammatory process and the pathophysiological mechanisms of depression. In this case-control study, we examined the levels of PUFAs and inflammatory cytokines in PND. MethodBlood samples were obtained and analyzed from 16 healthy controls and 17 depressed cases (PND group) diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Independent sample t-test and correlation analysis were performed with Statistical Package for the Social Sciences (SPSS) logistics correlation analysis. ResultsPND group had significantly lower levels of total n-3 (p=0.026), docosahexaenoic acid (DHA) (p=0.020) and eicosapentaenoic (EPA) (p=0.019) but a higher omega-6 (n-6)/n-3 PUFAs ratio (p=0.007) and tumor necrosis factor alpha (TNF-α) (p=0.016) level. Moreover, the duration of current PND episodes were also significantly correlated with DHA, EPA, n-3 PUFAs, n-6/n-3 ratio and TNF-α. In terms of PUFAs and cytokine levels, only DHA was inversely correlated with TNF-α. ConclusionPND is significantly associated with lower DHA, EPA, and total n-3 PUFAs levels and an increased n-6/n-3 PUFAs ratio, while the duration of PND is associated with lower levels of n-3 PUFAs, including DHA and EPA. The correlation of PUFAs levels with depression and TNF-α level grant further investigation into the inflammatory process underlying PND, mediated by PUFAs.

Uterine Anomalies and Hypertensive Disorders of Pregnancy: A Retrospective Study [1B

INTRODUCTION: Pregnancies associated with uterine anomalies have higher rates of recurrent pregnancy loss, preterm delivery and malpresentation necessitating cesarean delivery. Smaller studies have suggested the link between hypertensive disorders and uterine anomalies as well but thus far, there still remains little data regarding the subject. The purpose of this study was to compare rates of hypertensive disorders in pregnant women with a known uterine anomaly and compare it to the rate in the normal pregnant population. METHODS: Demographic and clinical characteristics of patients who were gravid for more than 20 weeks, had an uterine anomaly, and were seen at OhioHealth facilities from January 1, 2010 to October 7, 2015 were examined. The rate of hypertensive disorders among women with uterine anomalies was calculated and compared to the rate of hypertensive disorders among women without uterine anomalies (i.e., the normal pregnant population). RESULTS: From January 1, 2010 to October 7, 2015, there were 80 women seen at OhioHealth facilities who were gravid for more than 20 weeks and had a uterine anomaly. A greater proportion of women with a uterine anomaly had a hypertensive disorder (15.0%) than women without a uterine anomaly (5.0%) (p=0.001). CONCLUSION: A greater proportion of women with a uterine anomaly had a hypertensive disorder (15.0%) than women without a uterine anomaly (5.0%) (p=0.001). With increasing use of assisted reproductive technology, the OB/GYN community will begin seeing a greater number of these pregnancies. Understanding the specific pregnancy outcomes that are associated with these high risk pregnancies will be crucial for appropriate management.

Алгоритм скринінгової діагностики депресивних і тривожно-депресивних розладів у жінок під час вагітності та після пологів

Objective — to present developed by the authors and approved screening diagnostic algorithm of anxiety and anxiodepressive disorders in women during pregnancy and postpartum period. Materials and methods. In total 247 pregnant women at the midpregnancy aged 17 to 45 years were enrolled in a screening psychodiagnostic test that was carried out at the SI «Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine». Among them 67 pregnant women from 22 to 38 years of age with the high rates of anxiety score according to the state-trait anxiety and/or depression inventory and other scales were examined by applying the in-depth clinical and clinically psychopathological studies (the index group). The control group included 31 pregnant women from 24 to 39 years of age with the low rates of anxiety score according to the mentioned above tests. The step-wise screening diagnostic algorithm of anxiety and anxiodepressive disorders in pregnant women during second trimester and postpartum (6–8 weeks and at the end of 1-year term) period was developed by the clinicians of Center of psychosomatics and psychotherapy of children and women, and first implemented in practice at the Obstetric Clinic of the SI «Institute of Paediatrics, Obstetrics and Gynaecology of the NAMS of Ukraine» and then approved. Results. Data resulting from the screening psychodiagnostic study revealed the widespread phenomenon of anxiety and depression and its high rates according to anxiety and/or depression and other scales that prove the topicality of such a research focused on improvement of psychological counselling for pregnant women and mothers with babies. Conclusions. The efficiency of the developed step-wise screening diagnostic algorithm on early determination of depressive disorders in women during pregnancy and postpartum period, which must be implemented in medical, obstetric and specialized (psychological and psychiatric) fundamental practices with the aim of improving the quality of mental health care of pregnant women and mothers with babies. Key words: depression and anxiety disorders, pregnancy, postpartum period, postpartum depression, screening, informed consent, pathopsychological diagnostics.

Psychoemotional disorders in pregnancy with hypertensive complications

Psychoemotional disorders in pregnant women represent a significant medical and social problem as well as the effects caused by this pathology have a profound effect on children born to such mothers, as well as to themselves mothers during and after pregnancy. The goal–psychological correction of psycho-emotional states in pregnant women with hypertensive syndrome by Erickson hypnosis. The study was conducted on the basis of state organization “Research Center for Obstetrics, Gynecology and Perinatology named after Academician VI Kulakov”. The study involved 150 pregnant women with hypertensive syndrome. Seventy-five pregnant women with hypertensive syndrome received psychological correction method of Erickson hypnosis in an amount of 15 sessions. To assess the state of mental and emotional techniques used depression scale Beck Anxiety Scale, Spielberger-Hanin. The study was conducted 4 times–the first, second, and third trimesters of three months after childbirth. When comparing the psycho-emotional state of pregnant women with hypertensive syndrome on the background of psychological adjustment method Erickson hypnosis and in pregnant women with hypertensive syndrome who did not receive psychological correction revealed a statistically significant difference. In pregnant women with hypertensive syndrome who received psychological correction method of Erickson hypnosis, revealed lower levels of depression and situational anxiety than women who did not receive psychological correction. Thus, our study proved the need for psychological correction method of Erickson hypnosis and its effectiveness for stabilizing the psycho-emotional state of pregnant women with hypertensive syndrome and pre-eclampsia prevention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Корекція гемодинамічних порушень у вагітних із варикозною хворобою

The objective: determining of the characteristics of hemodynamic disorders in pregnant women with varicose veins. Patients and methods. The study involved 80 pregnant women with varicose veins of the lower limbs: 42 pregnant women with varicose veins of the lower extremities (study group) suggested usage of complex therapy; 38 pregnant women (group) – traditional therapy. Performed duplex mapping dopplerometry pool pelvic vein, external iliac and ovarian veins; pool venous legs, hip and great saphenous veins. The authors suggested regimen that includes use of drug Dioflan®. Results. Analysis of the data allowed to define features and its hemodynamic disturbances in venous pools pelvis and lower extremities in pregnant women with varicose veins. The study conducted by the authors proposed estimation methods of their correction using the drug Dioflan®. Conclusion. The proposed method is statistically more effective correction of hemodynamic disorders in pregnant women with varicose veins. Key words: pregnancy, varicose veins, dopplerometry, Dioflan®.

Association between dietary patterns and mental disorders in pregnant women in Southern Brazil.

Objective:To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil.Methods:Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants’ mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR).Results:In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93).Conclusions:Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.

Hypertensive disorders of pregnancy in women with gestational diabetes mellitus on overweight status of their children.

Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. The aim of the present study was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM).A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1–5 years old.Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1–5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08–2.79) and macrosomia (OR 2.02, 95%CI 1.23–3.31) at birth and childhood overweight/obesity at 1–5 years old age (OR 1.88, 95%CI 1.16–3.04).For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity, and controlling the maternal hypertension may be more important for preventing large for gestational age babies and childhood obesity.

Abstract P185: Hypertensive Disorders of Pregnancy in Women With Gestational Diabetes Mellitus on Overweight Status of Their Children

Background: Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. Aims: To evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM). Methods: A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1-5 years old. Results: Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1-5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08-2.79) and macrosomia (OR 2.02, 95%CI 1.23-3.31) at birth and childhood overweight/obesity at 1-5 years old age (OR 1.88, 95%CI 1.16-3.04). Conclusion: For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity.

Treatment of Prescription Opioid Use Disorder in Pregnant Women.

Treatment of Prescription Opioid Use Disorder in Pregnant Women.

Factors associated with the probability of common mental disorders in pregnant women: a cross-sectional study

Abstract Objective: To estimate the prevalence of probability of common mental disorders in pregnant women and associated factors. Methods: A cross-sectional study with a quantitative and descriptive approach was performed with 330 pregnant women enrolled in a Women's Health Service located in Mid-West Brazil. Data were obtained through a questionnaire about socio-demographic characteristics and family or personal history. The Self-Reporting Questionnaire and Poisson regression were applied to screen for common mental disorders, aiming to identify factors associated with it. Results: The prevalence of probability of common mental disorders among pregnant women was 57.1% and it was associated with marital status, gestational age, unplanned pregnancy and bleeding. Conclusion: The prevalence of pregnant women likely to have common mental disorders and the average Self-Reporting Questionnaire score estimated in this study were higher than those found in other studies with samples from the general population.

Intervención Grupal en Embarazadas: Respuestas Diferenciales de Acuerdo al Tipo de Depresión y Patrón de Apego

A partir de la alta prevalencia de trastornos depresivos en embarazadas, se describió y analizó la variabilidad en los resultados ante una intervención psicoeducativa grupal. Para ello se consideraron los tipos de depresión (DEQ) propuestos por Blatt (2004) y su asociación con el patrón de apego materno (ECR-S), analizando la respuesta a la intervención en sintomatología depresiva (BDI) y sensibilidad materna (CARE-Index). Se utilizó un diseño cuasi experimental (grupos experimental y control), longitudinal, descriptivo y comparativo, con una muestra intencional de 112 embarazadas con sintomatología depresiva, atendidas en 5 centros de salud pública de Santiago, Chile. Tras los análisis de varianza, los resultados mostraron que la intervención grupal resultó eficaz, reduciendo la sintomatología depresiva y favoreciendo adecuados niveles de sensibilidad materna. Sin embargo, las participantes con depresión introyectiva no disminuyeron su sintomatología depresiva, pero sí mostraron adecuados niveles de sensibilidad materna. Los resultados relevan la importancia de ofrecer otras modalidades de tratamiento para la depresión durante el embarazo, además de la grupal, considerando aspectos individuales. Se requieren estudios con muestras de mayor tamaño para confirmar estos hallazgos.

A Moral or Medical Problem? The Relationship between Legal Penalties and Treatment Practices for Opioid Use Disorders in Pregnant Women

ObjectiveThe relationship between use of medication-assisted treatment (MAT) in pregnant women with opioid use disorders, the standard of care, and state laws that permit child abuse charges for illicit drug use during pregnancy has not been described. MethodsUsing publicly available data on substance abuse treatment in the United States, we describe patterns in the use of MAT for pregnant women with opioid use disorders in states with prenatal child abuse laws compared with states without such laws. A binary logistic regression analysis was conducted to predict the presence or absence of MAT in the treatment plan of pregnant women using the following independent variables: state prenatal child abuse law, referral source, geographical region, and Medicaid coverage of methadone. ResultsIn 2012, there were 8,292 treatment episodes of pregnant women with a primary opioid use disorder in the United States for which data on MAT use were available. Among states with laws that permit child abuse charges for illicit drug use in pregnancy (18 states), MAT was used in 33.15% of treatment admissions compared with 51.33% of admissions in states without a law. The following levels of the independent variables have a greater effect on the lack of use of MAT in descending order of importance: criminal justice referral, other community referral, Southern region, Medicaid coverage, drug abuse care provider referral, unknown referral, other health care provider referral, and presence of state law that permits child abuse charges. ConclusionReferral source, geographic region, Medicaid funding, and prenatal child abuse laws were associated with significantly lower rates of use of MAT.

Содержание аргинина и аргиназы в плазме крови у беременных с задержкой роста плода

The objective: to determine arginine and arginase levels in the blood serum of pregnant women with intrauterine growth retardation of different severity. Patients and methods. The study included 100 pregnant women (from 23 to 40 weeks of gestation). The main group consisted of 80 pregnant women with intrauterine growth retardation. The control group consisted of 20 women with physiological course of pregnancy. The patients of the main group were divided into three clinical groups regarding intrauterine growth retardation staging. Group I included 38 pregnant women with stage I IUGR, 22 pregnant women with stage II IUGR were in group II and 20 pregnant women with stage III IUGR – in group III. L-arginine concentration was determined in the blood serum by the method of T.L. Aleinikova et al [1], arginase activity – by the method of J.W. Geyer, D. Dabich [4]. The statistical analysis was performed by using standard computer programs: STATISTICA 6.0, Microsoft Excel, ANOVA. Statistically significant difference was considered at p<0.05. Results. In the study the reduced level of free arginine in the main group of pregnant women with intrauterine growth retardation of different severity was determined if compared with the control group. Fetomaternal gradient of arginine is reduced significantly due to increasing activity of the enzyme arginase, which competitively uses amino acid. Conclusions. The level of reduced free arginine in the blood serum of pregnant women with intrauterine growth retardation is directly proportional to the severity of fetal growth retardation: the more severe fetal growth retardation, the more marked arginine deficiency. For correcting metabolic disorders in pregnant women with intrauterine growth retardation it is recommended to administer L-arginine containing drugs. Key words: L-arginin, arginase, blood serum, pregnant women with intrauterine growth retardation.

Markers of Endothelial Dysfunction as Criteria for Differential Diagnosis of Hypertensive Disorders in Pregnant Women

Markers of Endothelial Dysfunction as Criteria for Differential Diagnosis of Hypertensive Disorders in Pregnant Women

Thyroid Dysfunction And Pregnancy Outcome

Several studies conducted across the globe have reported a high prevalence of thyroid disorders in pregnant women. However evidence relating to adverse fetal and pregnancy consequences of maternal thyroid disorders are less well defined and not consistent. This study was thus conducted to find out the prevalence of thyroid disorders in pregnant ladies and to evaluate the adverse pregnancy outcomes in pregnant women with such disorders.This study was conducted in the Central Clinical Laboratory,of Gauhati Medical College & Hospital. Records of TSH reports of samples received from the obstetrics ward and the labour room were maintained and analysed. Follow up of all the cases included in the study was done with regards to fetal and pregnancy outcome with the help of labour room records.During the 1 year period of study 9117 samples were received . Of them 1671 (18.33%) were found to be hypothyroid and 137(1.5%) hyperthyroid. Pre-eclampsia was the most common adverse outcome observed in 20.83% of hypothyroid ladies as compared to 9.1% in ladies with normal TSH levels.Other adverse outcome was preterm birth in 14.8%, low birth weight 17.14% and fetal death in 3.89% of hypothyroid cases. In pregnant ladies with hyperthyroidism significantly high percentage of adverse outcome was also noted. Preeclampsia 15.33%, preterm delivery 10.21%, low birth weight 33.06%,and fetal death 2.19%.The findings of this study are in accordance with those of previous studies which have reported high incidence of adverse outcome in pregnant ladies with thyroid disorders. Considering the findings of this and other similar studies it is highly appropriate to consider routine screening of pregnant ladies with TSH test so that thyroid disorders can be diagnosed early in pregnancy and adequately treated to avoid the adverse consequences.

Тревожно-депрессивные расстройства у беременных с артериальной гипертензией

Тревожно-депрессивные расстройства у беременных с артериальной гипертензией