Universal screening for hypothyroidism in all antenatal women at tertiary center
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3889-3896
AbstractBackground: Maternal hypothyroidism in the most common thyroid disorder in pregnancy, has been associated with abortions, pre-eclampsia, preterm labor, placental abruption, and postpartum hemorrhage. Fetal complications include low birth weight babies, preterm delivery, intrauterine growth restriction, high rates of stillbirth and neonatal deaths, neonatal hyperbilirubinemia, higher incidence of neonatal hypothyroidism, and increased perinatal mortality.
Methodology: Prospective observational study was conducted to screen all antenatal women meeting inclusion and exclusion criteria. Higher values were further tested, treated and cases were followed up till delivery. Both maternal and neonatal outcomes documented.
Results: 703 antenatal women screened 62 were hypothyroid, prevalence was 8.8%.it was more in 34 to 40 years, multigravida, second trimester. The maternal outcome among hypothyroid women were abortion 6.5%, Preeclampsia 27.4%, GDM 4.8%, Oligohydramnios 4.8%, Abruptio placentae 8.1%, PPH 3.2%, Preterm labor 11.3%. The fetal outcome was LBW 11.3%, Low APGAR score 27.4%, IUGR 12.9%, Still birth 1.6%, IUFD 8.1%, NICU admission 25.8%, Hyperbilirubinemia 4.8%.
Conclusion: Thyroid screening is a must at first booking, preferably prenatally to prevent miscarriages. As fetus needs thyroxine for brain development, growth, and lung maturation, adequate replacement therapy should be done to keep TSH within trimester specific reference ranges. Significant adverse effects on maternal and fetal including lower neurocognitive effects were seen emphasizing the importance of routine antenatal thyroid screening.
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