Fetomaternal outcome of thyroid disorder in pregnancy

Background: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group and hence constitute the commonest endocrine disorder in pregnancy. It has been recognized that maternal thyroid hormone in excess or less can influence the outcome for mother and fetus at all stages of pregnancy as well as interfere with ovulation and fertility. Thyroid dysfunction is often overlooked in pregnant women because of the nonspecific symptoms and the hyper metabolic state of pregnancy. Hence thyroid function test becomes essential to know the thyroid status in pregnancy and also to detect the subclinical disease. The aim is to study the fetomaternal outcome of pregnant women with thyroid disorders. Methods: This study is an observational study carried on 500 women coming for antenatal check-up in Tertiary Care Hospital in Ahmedabad from January 2015-December 2015. All women who were included in this study were followed from 18-24 weeks of pregnancy up to delivery. Results: It was observed that the maximum numbers of patients were in 21-25 years (49%) age group. Euthyroid (86%), hyperthyroid (01%), subclinical hyperthyroid (02%), hypothyroid (03%), and subclinical hypothyroid (08%) cases were detected. Neonatal jaundice developed in babies of all hyperthyroid patients, 50% of patients with Subclinical hyperthyroidism, 53% of patients with Hypothyroidism, 60% of patients with Subclinical Hypothyroidism and 11% of patients with Euthyroid. Conclusions: TSH is the hallmark in detection of thyroid state of pregnant mother, so TSH should be included in the list of routine investigations done in all antenatal women in second trimester. If TSH values are abnormal then FT3 and FT4 levels need to be checked. Trimester specific reference intervals are of utmost importance by which clinicians can reliably evaluate thyroid function and monitor thyroxine replacement therapy in pregnant women.