RESUMO
Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.
RESUMO
Background: The incidence of cesarean section is steadily rising. Cesarean delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates. There are various factors involved in the rise of rate of cesarean section like rising incidence of primary cesarean delivery, identification of high-risk pregnancy, wider use of repeat cesarean section, rising rates of induction of labor and failure of induction, no reassuring fetal status etc.Methods: A retrospective cross-sectional study was conducted. Data was collected from patient records of the hospital during 1st January 2018 to 30th June 2018. All patients (N= 602) who had delivered their baby by caesarean section were included in the study. Data were analyzed by help of SPSS version 21 after proper compilation.Results: Among all women who underwent cesarean section, majority were age group between 21 and 30 years (67.1%). Repeat cesarean section (48.5%), followed by fetal distress (18.9%), oligohydramnias (6.6%) and cephalopelvic disproportion (6.5%) were most common among all major indication of cesarean section. Intrapartum complication (2.0%) includes postpartum hemorrhage (1.2%), CS hysterectomy (0.5%), bladder injury (0.3%) and postpartum complication (2.3%) including UTI (0.8), wound infection (0.5%), sepsis (0.5%), lactation failure (0.5%) were major maternal complication of cesarean section.Conclusions: Reduction of number of primary cesarean section, successful VBAC, individualization of the indication and careful evaluation, following standardized guidelines can help to keep rate of cesarean section to the possible minimum level.