ABSTRACT
Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Aim of this study was to identify thyroid dysfunction as a maternal health problem. Objective of this study was to study the maternal outcomes in these patients.Methods: The main source of data are the patients admitted in Sultania Zanana Hospital, GMC Bhopal. The study was an observational prospective study conducted from March 2018 to February 2019.Results: The present study was conducted in department of obstetrics and gynecology, Gandhi Medical College and associated Sultania Zanana Hospital Bhopal for the period of 1 year. The study could enroll 400 females fulfilling the inclusion criteria during the study period.Conclusions: In developing countries like India where there is prominent micronutrient deficiency, iodine deficiency further aggravates the condition and carries a great potential to show deleterious impacts on maternal and fetal outcomes, thus serving a major health problem. Considering the substantial increase in short term as well as long term perinatal morbidity, a felt need for creating awareness not only on adverse outcomes but also detection of the disorder in first trimester is required. The desired perinatal outcome can be achieved by early detection and prompt treatment of the disorder. Henceforth, universal screening of all antenatal women in the first trimester rather than targeted case finding should be recommended at all the health care facilities.
ABSTRACT
Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.
ABSTRACT
Iodine is considered as one of the essential elements for the proper functioning of the hormones of human and animal thyroid glands. In many parts of the world iodine deficiency disorders develop because of deficiency of iodine in water and food supply. An iodine deficient goitrous mother may give birth to a cretinous baby because the fetus requires an adequate secretion of thyroxine during the later stages of pregnancy. Seaweed has such a large proportion of iodine compared to dietary minimum requirements, that it is primarily known as a source of this nutrient. A trial study on supplementation of iodine rich seaweed Caulerpa racemosa availed from Gujarat coast was conducted on iodine-deficient or thyroid-insufficient (n=10) pregnant women. They were supplemented daily with 0.17 g of algae in 20 g wheat flour ladoo for one month so as to provide 50μg/day of iodine and 0.343 mg/day of iron. A slight non-significant increase (104.75 to 121.05 μg/L) in median urinary iodine concentration (UIC) was observed after one month of supplementation. No significant effect of supplementation was observed on thyroid function parameters of the subjects. They also showed slight increase in hemoglobin level. Prolonged supplementation needs to be carried out further to opine on the impact of algae.