Evaluation of Effects of Subclinical Hypothyroidism on Pregnancy and Its Outcome

Sreelakshmi.U, Divya J Tekani

Abstract: Objective To evaluate the effects of subclinical hypothyroidism on pregnancy, pattern of obstetric complications and its outcome. Materials and methods This prospective observational study conducted from Feb 2011 to Nov 2014 in obstetrics and gynecology department, VYDEHI INSTITUTE OF MEDICAL SCIENCES AND RESEARCH CENTRE, BANGALORE. At first antenatal visit pregnant women were screened for TSH and further evaluated for FT4 and FT3 if found elevated TSH above 2.5 international units (IU) /ml in first trimester and above 3 IU/ml in second trimester. Following confirmed subclinical hypothyroidism, treatment was initiated with Levothyroxine. Maternal outcomes were studied. Results Prevalence of subclinical hypothyroidism in pregnancy was 2.07 %. TSH was found less than 6 IU/ml in 41 cases, between 6-10 IU/ml in 37 cases, more than 10 IU/ml in 23 cases. Threatened abortion was observed in (44.55 %) 45 cases, 25 (24.75 %) cases had preterm delivery. Cesarean section rate was 27.7 % (28). Intra uterine growth retardation was seen in 5 (5 %) cases. Intrauterine death was seen in 15 (15 %) cases. Conclusion Subclinical hypothyroidism in pregnancy is significantly associated with obstetric complications. Early diagnosis, active intervention, multidisciplinary team approach i. e. endocrinologist, skilled obstetrician, physician, anesthetist, and proper facilities for ante partum and intrapartum care is required for the management of hypothyroidism and its complications.

Keywords: Sub clinical hypothyroidism, complications, pregnancy, maternal outcomes