FETOMATERNAL OUTCOME IN MATERNAL HYPOTHYROIDISM COMPLICATING PREGNANCIES AT RIMS: A PROSPECTIVE STUDY.

M.S. Rajalakshmi, P.G. Trainee, Y. Ajit Kumar Singh, Assisstant Professor, Sujit Das, P.G. Trainee, Samchetsabam Randhoni Devi Professor.

ABSTRACT

Objective: To analyze the fetomaternal outcome in maternal hypothyroidism complicating pregnancies at RIMS, Imphal. Study Design: We conducted a Prospective Study in the Department of Obstetrics and Gynaecology, RIMS, Imphal, Manipur. The study included 300 pregnant women attending antenatal clinic of Obstetrics and Gynecology, RIMS, Imphal between October 2013 to March 2015.The variables were age, parity, period of gestation, obstetrical history, haemoglobin of mother, Apgar score, birth weight etc. Data were analyzed by Chi-square test using SPSS Programme. Results: Among 300 selected women overt hypothyroid patients were 14 (4.7%) and subclinical hypothyroid patients were 286(95.3%). Threatened abortion, as a complication occurred in 10 patients (3.3%). In the 2nd trimester follow up 268 patients (92.3%) were compliant and in the third trimester 236 patients (78.7%) were compliant. 16(5.5%) Patients had pre eclampsia (overt hypothyroids were 2 and subclinical hypothyroids were 14). Preterm labour was found in 12 cases. Maternal complications like PPH were found in 48.1% of the patients, who were not compliant. Low birth weight is reported in 22.2% of respondents who were non compliant and only in 14.4% of who were compliant, P value (<0.05) is significant. In non compliant group, 74.1% of the neonates developed RDS compared to only 6.7% of the neonates in the compliant group. . NICU admissions contributed to 63% in the non compliant group compared to 0.8% in the other group. Neonatal thyroid screening was abnormal in 7.4% of non compliant group and nil in the other group. Conclusion: Our study proves significant association between uncontrolled hypothyroidism and adverse fetomaternal outcome The pregnancy outcome observed in our subjects (compliant) was better. There was very low incidence of still birth, preterm deliveries, deaths etc. This might have been due to the thyroid hormones of mother which were maintained within the reference range.

Keywords: haemoglobin, fetomaternal, hypothyroids.