THYROID HORMONE AS A RISK FACTOR FOR MISCARRIAGE!!

Dr Yashi Srivastava, Dr Urvashi Barman Singh, Dr Meena Dayal, Dr Shakti Jain

Abstract


 Aim: Abnormal thyroid hormone levels could give rise to increased placentation defects that underlies the association between maternal thyroid dysfunction and adverse pregnancy outcomes. This study was designed to analyze the thyroid hormone profile in the study groups and its possible association with the risk of abortion during pregnancy.

  Methodology: This was a analytical observational cohort study conducted over a time period of 1 year, on 120 women attending the antenatal clinic in Department of Obstetrics and Gynaecology, Swaroop Rani Nehru Hospital, Prayagraj. The patients were divided into two groups, Group 1 (n = 80) included women with previous history of abortions and group 2 (n = 40,control group) included women with no history of abortions. S.T3, S.T4 and TSH levels were estimated and compared in both the groups.

Result: In the present study, the abortion rate was higher in the hypothyroid group as compared to euthyroid group (p < 0.05). TSH was found to be strongly associated with abortion in the cases (p≤ 0.001). TSH levels were significantly higher in women who had an history of previous pregnancy loss than the women who had successful continuation of pregnancy. 

Conclusion: S.TSH was found to be strongly associated with abortions, mainly in the first trimester, in both the groups. Thus, screening of thyroid dysfunction in early pregnancy has clinical significance and adequate T4 replacement therapy if given in cases of hypothyroidism would help to reduce the risk of miscarriage in these women.


Keywords


THYROID HORMONE, placentation, pregnancy, Recurrent Miscarriage

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References


Stirrat GM. Recurrent miscarriage. Lancet 1990;336:673–5.

Tho PT, Byrd JR, McDonough PG. Etiologies and subsequent reproductive performance of 100 couples with recurrent abortion. FertilSteril 1979;32: 389–95.

Stephenson MD, Kutteh W. Evaluation and management of recurrent early pregnancy loss. ClinObstetGynecol 2007;50:132–45.

Royal College of Obstetricians and Gynecologists. Royal College of Obstetricians and Gynecologists, Scientific Advisory Committee, Guideline No. 17. The investigation and treatment of couples with recurrent miscarriage. Published May 2011. Available at: https://www.rcog.org.uk/en/guidelinesresearch-services/guidelines/gtg17/. Last accessed January 25, 2016.

American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent pregnancy loss. No. 24. February 2001. [Replaces technical bulletin no. 212, September 1995]. Int J GynaecolObstet 2002;78:179–90.

Sarkar D. Recurrent pregnancy loss in patients with thyroid dysfunction. Indian J EndocrinolMetab. 2012;16(Suppl 2):S350–S351. doi:10.4103/2230-8210.104088

Kennedy RL, Malabu UH, Jarrod G, Nigam P, Kannan K, Rane A. Thyroid function and pregnancy: Before, during and beyond. J ObstetGynaecol. 2010;30:774–83.

Pereira N, Setton R, Petrini AC, Lekovich JP, Elias RT, Spandorfer SD Is anti-Müllerian hormone associated with IVF outcomes in young patients with diminished ovarian reserve? Women Health (Lond). 2016; 12(2):185-92.

Hirsch D, Levy S, Nadler V, Kopel V, Shainberg B, Toledano Y. Pregnancy outcomes in women with severe hypothyroidism. Eur J Endocrinol. 2013 Jul 29;169(3):313-20. doi: 10.1530/EJE-13-0228. Print 2013 Sep.

Taylor PN et al. TSH levels and risk of miscarriage in women on long-term levothyroxine: a community-based study. J ClinEndocrinolMetab. July 24, 2014 [Epub ahead of print].

Negro R, Schwartz A, Gismondi R, et al. Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. Journal of Clinical Endocrinology and Metabolism. 2010;95: 1699–1707.


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