Maternal Serum TSH Value in Early Pregnancy and its Relation with Pregnancy Outcome

Introduction: Thyroid disorders in pregnancy are among the common endocrine disorders. During pregnancy several physiological changes occur in maternal thyroid function and failure to adapt to these changes result in thyroid dysfunction. Thyroid dysfunctions have many adverse effects on mother and fetus, like miscarriages, preeclampsia, eclampsia, placental abruption, preterm delivery, low birth weight, post partum haemorrhage, neonatal hypothyroidism and impaired neurological and intellectual development of fetus. Study aimed to find out the prevalence of thyroid dysfunction in pregnancy and to know maternal and foetal outcome. Material and methods: This cross sectional clinical study was carried out at Obstetrics and Gynecology department in collaboration with Biochemistry Department, IGIMS, Patna, Bihar from August 2018 to August 2019 including 100 pregnant women with single intrauterine pregnancy in first trimester between 6-14th weeks of gestation. TSH level was estimated in all the pregnant women along with FT3, FT4, and Anti TPO Ab. According to the thyroid profile, patients were divided into 4 groupsNormal/ Subclinical/ Overt hypothyroidism and hyperthyroidism and followed till delivery for maternal and perinatal outcome. Results: In our study of 100 patients, 87 were found to have normal thyroid function and 13 cases were having subclinical hypothyroidism, using a cut off TSH level of 2.5-10uIU/ml in AntiTPO Ab positive and 4-10uIU/ml in AntiTPO Ab negative cases. No case of hyperthyroidism or overt hypothyroidism was found. These 100 patients were divided into two groups. Patients having normal thyroid function were included in Group 1 and patients with subclinical hypothyroidism were included in group 2. In subclinical hypothyroidism group 5(38.46%) cases were AntiTPO Ab positive and 8 cases were AntiTPO Ab negative. Conclusion: Our study concludes that there is high prevalence of subclinical hypothyroidism (13%) in pregnant women during 1st trimester. No significant difference was seen in maternal and foetal outcome between euthyroid patients and treated subclinical hypothyroid patients.