Pregnancy

BACKGROUND: Both anemia and thyroid disorders are common public health problems with pregnant women being the most vulnerable group. The risk of maternal mortality has a direct correlation with the severity of IDA (Iron Deficiency Anemia). OBJECTIVES: The study aimed to observe the prevalence of anemia and evaluate the level of thyroid hormones in pregnant women and to study their inter-relationship. MATERIALS AND METHODS: A total of 100 antenatal cases of women with the reproductive age group of 20-40 years have been included in the study. Subjects were categorized into three trimesters of pregnancy, viz. first trimester, second trimester and third trimester and their blood samples were analysed for biochemical and hematological parameters. RESULTS: It has been observed that 57% of pregnant women enrolled were anemic with Hb less than 11 g/dl. Based on the haematological studies, the anemic condition was due to the deficiency of iron. Further, thyroid function was found to be correlated with iron deficiency anemia. Subclinical hypothyroidism was found in 49% of anemic subjects. CONCLUSION: Subclinical hypothyroidism is more pronounced effect than overt hypothyroidism due to iron deficiency anemia in pregnancy as revealed from the data generated in the study. Screening of thyroid stimulating hormone in all pregnant women at time of first visit and treatment should be started if TSH <2.5IU/ml for healthy feto-maternal outcome. It has been established from the present study, that anemia can worsen this condition further, since iron deficiency is a major public health problem in developing country like India.

ABSTRACT Hypertensive disorders complicate 12% to 22% of all pregnancies. Intrauterine growth restriction is one of the fetal outcomes in mothers with hypertension. Doppler studies are done to predict pregnancy outcome in patients with hypertension. We planned this study to determine the role of uterine artery Doppler at 22 to 26 weeks of gestation for predicting IUGR in women with pre-existing hypertension. A cross sectional validation study was undertaken in the Department of Obstetrics & Gynaecology, MCH Center, Unit I, PIMS, Islamabad from June 2014 to June 2015. Both primigravida and multigravida women with pre-existing hypertension were enrolled. Pregnancies with congenital abnormalities, complications like diabetes, cardiac disease and autoimmune disease were excluded. Women without satisfactory attainment of sonography due to technical reasons, lost to follow-up and cases who were not delivered in MCH Center, PIMS, were also excluded. There were 15 (26.7%) cases of IUGR in normal RI Doppler group and 20 (35.7%) abnormal RI Doppler group. The average birth weight was slightly higher in normal RI group 2.9 + 1.1 kg compared to 2.3 + 0.7 kg in abnormal RI group. RI on Doppler ultrasound had sensitivity and specificity of 57.1% and 53.2% in predicting IUGR whereas the PPV and NPV were found to be 35.7% and 73.2% respectively. RI on Doppler ultrasound is a reasonably good predictor of IUGR. Though it was reasonably sensitive the value of PPV was not that high (35.7%). Keywords; Pregnancy, pre-existing hypertension, uterine artery Doppler, IUGR