Outcome of thyroid dysfunction in pregnancy in Mashhad, Iran

Thyroid disorders are common in women during pregnancy, when the excess or deficiency of maternal thyroid hormones has been associated with adverse health outcomes for both the mother and child. This study performed to study the prevalence of thyroid disorders and its effect on pregnancy outcomes in pregnant women. In 500 pregnant women in first trimester of pregnancy enrolled for the study, Serum Thyrotropin [TSH], Free T4 [FT4], and Free T3 [FT3] were measured by high-sensitive radioimmunoassay. Overt hyperthyroidism was diagnosed when both TSH was suppressed and FT4 or FT3 were elevated. Sub-clinical hyperthyroidism was diagnosed when TSH was suppressed with normal FT4 and FT3. The diagnostic criteria for overt hypothyroidism was TSH> 4 mU/L accompanied by decreased FT4, and for subclinical hypothyroidism a TSH> 4 mU/L with normal FT4 level. Those with thyroid disorders were referred to an endocrinologist for medical treatment and all subjects were followed until delivery. Mean age of women was 24.5 +/- 4.9 years. Hypothyroidism, both subclinical [7.4%] and overt [2.4%], was found in 49 [9.8%] women. Overt hyperthyroidism found in 3 [0.6%] and subclinical hyperthyroidism in 21 [4.2%] women and was considered a physiologic change of pregnancy. On follow up, 19 women [3.8%] had preterm labor, and 25[5%] women developed pre-eclampsia. There was no significant difference in the incidence of preterm labor and pre-eclampsia in pregnant women with or without thyroid dysfunction. Normal neonates were born to 498 women, while 2 [0.4%] euthyroid mothers delivered fetuses with anomalies. Although thyroid dysfunction is common in pregnant women, the prevalence of complications is not higher in patients with thyroid dysfunction, as compared to normal euthyroid controls

[Serum human chorionic gonadotropin as a predictor of outcome in assisted reproductive technology pregnancies]

Assisted reproduction treatment [ART] entails a risk of ectopic pregnancy and early pregnancy loss. Serum sharp s-human chorionic gonadoropin [sharp s-hcg] has been found to be predictive of pregnancy outcome. Our aim was to determine whether serum sharp s-hcg levels obtained 16 days after ovulation are reliable predictors of pregnancy outcome. In this retrospective study, 200 women who have achieved a pregnancy through ART treatment at the infertility clinic of Mashhad Medical Sciences University were evaluated. The treatment included IUI in 196 [98%], ICSI in 2 [1%] and IVF in 2 [1%]. Serum samples were obtained on days 16 and serum sharp s-hcg concentration was measured by immune-radiometric assay. The mean age at treatment was 29 [range 19-35 y]. One hundred and sixty women aged above 30 y and 40 cases aged below 30 y .Out of 200 patients with ART cycles 175 cases were found to be viable pregnancies [live fetus at 20 weeks gestation] and 25 patients resulting in spontaneous abortion. A statistically significant difference was found between the mean sharp s-hcg value of the non-viable and viable pregnancies [P<0.001]

[Comparative evaluation of tubal sterilization by two method laparoscopy Filishie clips and minilaparotomy pomeroy technique]

Sterilization is the most prevalent means of family planning these days. Throughout the world, and different techniques have been employed to achieve this end. In this study two techniques of sterilization are being compared. 196 women who desired for sterilization, were randomly assigned in two groups: laparoscopy - Filishie clips [96 cases] and laparotomy-Pomeroy technique [100 cases]. We compared the duration of operation, surgical complications, post operative pain, wound infection and a long term follow-up [1-4 years] for changes in menstrual cycles, pelvic pain and failure rate. The mean duration of the procedure was shorter for the Flishie clips [P<0.07]. Post operative pain was lesser for clips [P=0.072]. The failure rate was 1.72% for clips and for Pomeroy it was 0% [P<0.05]. Other complications did not show significant differences. The Filshie clips technique as a sterilization procedure is simple and without any danger, can be conducted by means of laparoscopy and laparotomy, does not need much expertise, and as regards cosmetic effect and duration of operation seems better

Human chorionic gonadotropin as a predictor of outcome in assisted reproductive technology pregnancies

Objective: after assisted reproductive technology [ART] cycles, elevated serum hCG at 16 days after ovulation is used as an endocrine marker of pregnancy. The goal of this study is to determine whether serum hCG level obtained 16 days after ovulation is a reliable predictor of pregnancy outcome

Material and Method: this is a retrospective study in women who have achieved pregnancy through ARJ treatment, in Montaserieh Hospital [IVF center]. Analysis of data using logistic regression [stata] to predict a binary outcome: Ongoing pregnancy or miscarriage. Pregnancy was defined as progression to >20 weeks gestation. Miscarriage included spontaneous abortion, blighted ovum, or ectopic pregnancy

Results: human chorionic gonadotropin [hCG] was found to be the main determinant of pregnancy; age had minor effects; whereas luteal support and treatment types were nonpredictive. Low hCG levels between 25-50 Iu/L were associated with a low probability of ongoing pregnancy [<25%], whereas levels of 200lU/ L and higher predict a >96% chance of ongoing pregnancy

Conclusions: a single serum hCG level 16 days after ovulation provides a useful predictor of pregnancy outcome