Maternal Outcome of Hypothyroidism in Pregnancy- a South Indian Perspect

Nirmala C¹, Jayakumari C², Rajasekharan C^3, and Nandini VR⁴

¹Professor and Head, Department of Obstetrics and Gynecology, Sree Avittom Thirunal Hospital, Medical College, Thiruvananthapuram

²Associate Professor of Medicine, Department of Medicine, Medical College Hospital, Thiruvananthapuram

³Professor of Medicine, Department of Medicine, Medical College Hospital Thiruvananthapuram

⁴Associate Professor, Department of Obstetrics and Gynecology, Sree Avittam Thirunal Hospital, Medical College

Cite this paper

Nirmala C, Jayakumari C, Rajasekharan C and Nandini VR. Maternal Outcome of Hypothyroidism in Pregnancy- a South Indian Perspect. American Journal of Clinical Medicine Research. 2014; 2(2):47-50. doi: 10.12691/AJCMR-2-2-2

Abstract

Background: Hypothyroidism in pregnancy is increasing and is a major cause for concern because of its association with adverse maternal outcome if untreated. The literature related to the burden of adverse pregnancy outcomes associated with hypothyroid pregnant women on thyroxine replacement therapy is limited. Hence, this study was designed. Objective: The primary objective was to study the maternal outcome of hypothyroidism in pregnancy. Methodology: This study was conducted in the Department of Obstetrics & Gynecology in Govt. Medical College Trivandrum. This was a mixed method study that included retrospective patient data collection and a prospective matched case control study. Seventy-eight pregnant women were recruited as cases based on diagnosis of hypothyroidism prior to pregnancy from the medical department records. They were compared with 78 euthyroid pregnant women, approximately age matched. History and pregnancy outcome were assessed. Data was analyzed using SPSS statistical package. Results: Hypothyroidism was associated with 3.6 times higher risk of developing threatened abortion and 3.8 times higher risk of developing gestational hypertension (P=0.001). Rate of caesarian section (51.3%) and postpartum hemorrhage (12.8%) were higher among cases. Conclusions: Based on our study we conclude that hypothyroid mothers, in spite of thyroid replacement therapy, are at significantly higher risk of obstetric complications. A multidisciplinary team approach, where the services of an endocrinologist and an obstetrician experienced in high risk pregnancy care are used, and a tertiary level institution with good facilities for ante partum and intrapartum care, is essential to improve the outcomes.

Keywords

endocrine, hypothyroidism, pregnancy outcome, pregnancy complication, maternal thyroid dysfunction

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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