Study on comparison of maternal and fetal outcome in hypothyroid pregnancies with and without hypertension: a controlled case study

Abstract

Background: Incidence of subclinical hypothyroidism is 2.3% of pregnancies and overt hypothyroidism being 0.2%.Further incidence of hypertension one of the complications of maternal hypothyroidism strongly correlates with the levels of serum thyroid stimulating hormone (TSH). This study is designed to study maternal and fetal outcome in hypothyroid normotensive pregnancies (group 1) and hypothyroid hypertensive pregnancies (group 2) and to study the severity of hypertension in relation to thyroid function levels.Methodology: The prospective study was conducted on antenatal mothers attending MGMH,Petlaburz,OsmaniaMedicalCollege,Hyderabad during the period November 2012 to May 2014.The study was based on the analyses of 50 pregnant mothers diagnosed to have hypothyroidism .These included cases diagnosed before as well as during pregnancy .Another 50 pregnant mothers diagnosed to have hypothyroidism and developed hypertension during the course of pregnancy. Follow up was done with serum TSH and free T4 levels throughout pregnancy and outcomes were studied. Trimester specific values for thyroid function tests are used. Results: Cases suffering from overt hypothyroidism were 50% in group2 compared to 30% in group1 (chi-square=5.997, p value=0.04986).GHTN was seen in 52% of group 2 patients of which 12% belong to overt hypothyroid group. On the other hand 42% suffered from preeclampsia of which 32% belong to overt group (chi-square=16.55,p value=0.00236). A change in dosage was required in 36% in group1 & 42% in group2. Complications - preterm (grp1 4% & grp2 10%), IUD (grp1 2% & grp2 10%), IUGR (grp1 6% & grp2 14%) and Abruption (grp1 2% & grp2 6%) were observed. Conclusion: Changes in the thyroid hormone levels might be correlated with occurrence and severity of pre-eclampsia.