Context:Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases.Aims:We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester.Settings and Design:86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Material and methods: Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester.Statistical Analysis:SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis.Results:The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester.Conclusions:The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.

Blood samples from 11 baby elephants, 14 tuskers, and 16 females comprising 5 pregnant and 11 nonpregnant nonlactating elephants (Elephas maximus) were analyzed to assess the hematological values and the influence of age, sex, and pregnancy on these. The results obtained show that, compared with other mammals, the erythrocyte count in the blood of elephants is low and the mean corpuscular volume (m.c.v.), mean corpuscular hemoglobin (m.c.h.), and erythrocyte sedimentation rate (e.s.r.) are high. The very high values for m.c.v. and m.c.h. and the low erythrocyte count seen in elephants suggest that in the evolution of blood though they are more advanced than reptiles and birds in having eliminated the nuclei from the erythrocytes, they are still in the primitive state compared with the other mammals in as much as their erythrocytes have not attained the efficiency in the transportation of blood gases that results from a reduction in size to facilitate numerical increase. A low erythrocyte count and packed cell volume, a high e.s.r., an increase in neutrophils, and a decrease in the percentage of lymphocytes and eosinophils characterize pregnancy. In baby elephants there is an increase in the total leucocyte and lymphocyte counts and a decrease in eosinophils.

Screening for macroprolactin is a key element of laboratory assessment for hyperprolactinaemia.In cases where measured total prolactin is significantly raised, quantitative reporting of estimated monomeric prolactin instead of just 'macroprolactin' positive' can avoid unnecessary investigations.

Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and iron deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women.

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