ABSTRACT
Background: Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction, especially if complicated by the presence of thyroid antibodies. The presence of TPO-Ab is associated with increased rate of pregnancy complications such as miscarriage, preterm delivery, placental abruption, pregnancy-induced hypertension, intrauterine death and low birth weight. Objective of this study was to study the effect of anti-TPO Ab positivity on pregnancy outcome and estimate the prevalence of anti-TPO Ab in euthyroid obstetric women.Methods: This observational study enrolled 500 euthyroid pregnant women, age 20-35 years, up to 20 weeks gestation. Venous blood samples collected and analyzed for the anti TPO Ab levels. On the basis of anti TPO Ab positivity they were divided into two groups, anti-TPO Ab positive and Ab negative group. These two groups were followed up till delivery or abortion and compared for maternal and fetal outcomes.Results: Prevalence of anti-TPO antibody positivity was 5.2% in euthyroid obstetric women. Most of anti-TPO Ab positive women were overweight. There were higher numbers of miscarriage (11.54%) in anti-TPO Ab positive euthyroid pregnancies than (2.53%) in antibody negative women. Incidence of low birth weight babies was 4-fold higher in anti-TPO Ab positive women. More than two-fold increase in incidence of placental abruption in anti-TPO Ab positive women. Parity, anaemia, gestational hypertension, preeclampsia, GDM, PROM, PPH, low Apgar scores, NICU admission, IUD and neonatal death were not significantly associated with anti-TPO Ab positivity.Conclusions: Anti TPO Ab positivity significantly associated with pre-pregnancy BMI, miscarriage rates and low birth weight of newborns.
ABSTRACT
Background: The objective of this study is to assess the effectualness and safety of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy.Methods: This institution based contingent study was conducted on 220 women requesting for mid-trimester termination of pregnancy between 12-20 weeks with legal indication as per Govt. MTP act. After excluding the women as per exclusion criteria, they were randomly allocated into two groups (Group A Sublingual, Group B Oral), the women received 200 mg oral mifepristone followed by sublingual or oral misoprostol 400µg three hourly for a maximum of 5 doses 48 hours later. The course of misoprostol was reiterated if women failed to abort in 24 hours.Results: The mean induction-abortion interval of Group-A and Group -B was 4.02±1.39 hours and 6.44±1.79 hours respectively. The mean dose of misoprostol in Group–A and Group-B was 680±220.4µg and 1003.6±274.9µg. Hence mean Induction-abortion interval and dose were shortened in Group-A as compare to Group-B (p <0.05). There was 100% success rate noticed via both routes. Evacuation was done in 4 (3.64%) women in Group-B as compare to only 1 (0.91%) in Group-A . The acceptability was significantly more in Group-B (100%) as compare Group-A (52.73%), probably because of unpleasant taste of sublingual misoprostol. All side effects (Nausea, pain, headache, and diarrhea) were common in both the Groups, only fever was significantly more common in sublingual group as compare to oral group (p<0.05).Conclusions: From present study authors conclude that, sublingual misoprostol when combined with mifepristone is effective for medical abortion in second trimester in terms of effectualness, endurability and success rate than oral route.