Thyroid screening in pregnancy -A study of 82 women

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• 作者：Sejekan Prema B (1)
  
• 关键词：screening in pregnancy ; thyroid and pregnancy ; hypothyroidism
• 刊名：The Journal of Obstetrics and Gynecology of India
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：60
• 期：3
• 页码：232-236
• 全文大小：3105KB
• 参考文献：1. Spong CY. Subclinical hypothyroidism: should all pregnant women be screened? Obstet Gynecol 2005;105:235-36.
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• 作者单位：Sejekan Prema B (1)
  
  1. Gangadhar Clinic, 1681, 4th Cross, 8th Main Hall-3rd Stage, Bangalore, 560075, Karnataka, India
  

文摘

Objectives To create awareness, lay down a new criterion to pick up probable cases, and draw a proper management protocol for hypothyroidism in pregnancy. Methods Inclusion criteria -All normal pregnant women and those with thyroid problems were included in the study. Exclusion criteria -All others who had diabetes, collagen disease, heart disease with pregnancy were excluded from the study. Eighty two women were screened for hypothyroidism in pregnancy using T3, T4, TSH and FT4. A new screening criterion was followed [TSH value -0.5-.5 mIU/ml i.e biological range]. Women with TSH in pregnancy were followed up. Women with TSH value above 3mIU/ml, were considered hypothyroid and received treatment with L-Thyroxin. The group with a TSH value 2- mIU/ml was assessed with FT4. Those with low values or those with increasing TSH value on subsequent follow up received treatment. Results Study group consisted of 62 Primigravidae and 20 multigravidae. A. 40[32P + 8M] > 3 TSH value, these women received treatment with L-Thyroxin B. 24[16P + 8M] 2- TSH value, C. 18[14P + 4M] <2 TSH value. According to thyroid status, they were categorized into euthyroid -[27 true euthyroid + 4 potential hypothyroid] and overt hypothyroid -[43 adequately treated and 6 inadequately treated], two were untreated. Inadequately treated and potential hypothyroid pregnant women landed with miscarriages or pregnancy inducted hypertension, oligohydramnios and IUGR. Conclusions Potential and inadequately treated hypothyroid patients present with problems in pregnancy, while adequately treated hypothyroid and true euthyroid women get normal ongoing pregnancies. So to identify these potential or overt hypothyroid women, thyroid screening with T3, T4, TSH and FT4 must be done during prenatal period, at first booking, and repeated at 8 weeks interval thereafter, in pregnancy. TSH value should be kept below 2mIU/ml to get adequate control.