An Analytical Cross Sectional study on Hypothyroidism in Pregnancy, Its Maternal and Fetal Outcome

AIMS AND OBJECTIVES: 1. To assess the prevalence of hypothyroidism in pregnant women. 2. To analyse the maternal and foetal outcome of pregnancies complicated by hypothyroidism. 3. To determine whether Thyroid Function Test can be recommended as a universal screening or high-risk screening test for the pregnant mothers. MATERIALS AND METHODS: The study was conducted in the Department of Obstetrics and Gynaecology at Government Kilpauk Medical College and Hospital, Chennai from September 2017 to July 2018. Antenatal mothers were screened in the third trimester for the thyroid dysfunction and those with abnormal TFT were grouped into subclinical and overt hypothyroid groups. They were treated and followed up till delivery and the pregnancy outcomes were noted and analysed. RESULTS: In our study, the prevalence of hypothyroidism was 10.5%, overt and subclinical being 3.97% and 6.55% respectively. Incidence of complications were significantly higher in overt hypothyroidism compared to subclinical hypothyroidism namely anaemia (35% vs 15%), preeclampsia (49% vs 16%), preterm birth (38% vs 20%), low birth weight (41% vs 21%). 18 out of 25 adequately treated overt hypothyroid patients and 8 out of 35 developed complications in our study. CONCLUSION: We conclude that the course of the disease depends partly on the degree of hypothyroidism and partly on the treatment acquired. Timely identification, early initiation of the treatment and close monitoring regarding the dose titration plays a vital role in preventing the development of maternal and fetal complications. The prevalence and complications being high in our study and as per Indian Thyroid Society guidelines, it’s better to recommend screening of TSH levels in all the pregnant women at their first visit ideally during the pre-pregnancy evaluation or as early as the pregnancy is confirmed