Deeksha Joshi1, Rupali Dewan2, Rekha Bharti3, Karishma Thariani4, Aanchal Sablok5, Manjula Sharma2, Krishna Biswas6, Aruna Batra7. 1. Assistant Professor, Department of Obstetrics & Gynaecology, SAIMS , Indore, India . 2. Professor & Consultant, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India . 3. Assistant Professor, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India . 4. Reserch Officer, Human Reproductive Research Centre, ICMR & Ex senior resident, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India . 5. Senior resident, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India . 6. Associate Professor & Head of Endocrinology department, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India . 7. Ex Head of the Department, Consultant & Professor, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
Abstract
INTRODUCTION: Evidence suggests that by using the classical non pregnant reference range for serum TSH (STSH), one might miss hypothyroidism in pregnancy. Therefore, upper normal cut off value of S TSH should be taken as <2.5 mIU/L in the first trimester and <3mIU/L in the second and third trimester. However, two Indian studies have reported higher trimester specific reference ranges in the Indian pregnant women. OBJECTIVES: To assess the maternal and fetal outcomes using new screening criteria with upper S TSH cut off as >3mIU/L, for diagnosing hypothyroidism in pregnancy. MATERIALS AND METHODS: This study was a cross sectional study, carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, in collaboration with the Department of Endocrinology. Pregnant women with ≤ 20 weeks gestation, attending antenatal OPD from December 2010 to January 2012 were included in the study. On the basis of S TSH level, women were divided into Study Group with S TSH level between 3.1 to 6.2 mIU/L, (new range to be studied) and an equal number of age and parity matched Control Group with S TSH levels between 0.4 to 3 mIU/L. The maternal and fetal outcomes were compared between study and control groups. RESULTS: During the study period, a total of 66 women had S TSH between 3.1-6.2 mIU/L. Maternal and fetal outcomes in both the groups were comparable. There was no difference in the mode of delivery between study and control groups. CONCLUSION: The lower S TSH cut off recommended for diagnosing hypothyroidism in pregnancy may not be applicable to pregnant Indian women.
INTRODUCTION: Evidence suggests that by using the classical non pregnant reference range for serum TSH (STSH), one might miss hypothyroidism in pregnancy. Therefore, upper normal cut off value of S TSH should be taken as <2.5 mIU/L in the first trimester and <3mIU/L in the second and third trimester. However, two Indian studies have reported higher trimester specific reference ranges in the Indian pregnant women. OBJECTIVES: To assess the maternal and fetal outcomes using new screening criteria with upper S TSH cut off as >3mIU/L, for diagnosing hypothyroidism in pregnancy. MATERIALS AND METHODS: This study was a cross sectional study, carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, in collaboration with the Department of Endocrinology. Pregnant women with ≤ 20 weeks gestation, attending antenatal OPD from December 2010 to January 2012 were included in the study. On the basis of S TSH level, women were divided into Study Group with S TSH level between 3.1 to 6.2 mIU/L, (new range to be studied) and an equal number of age and parity matched Control Group with S TSH levels between 0.4 to 3 mIU/L. The maternal and fetal outcomes were compared between study and control groups. RESULTS: During the study period, a total of 66 women had S TSH between 3.1-6.2 mIU/L. Maternal and fetal outcomes in both the groups were comparable. There was no difference in the mode of delivery between study and control groups. CONCLUSION: The lower S TSH cut off recommended for diagnosing hypothyroidism in pregnancy may not be applicable to pregnant Indian women.
Entities:
Keywords:
Endocrinological disorders; Reference values; Screening in pregnancy; Serum TSH
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