To Study the Thyroid Profile in Postpartum Period “A Prospective Study”

Abstract

BACKGROUND A healthy and well-functioning thyroid gland is important to everyone, but it is especially important to a woman in their child bearing age. Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on autoimmune inflammation of thyroid gland. (1,2) AIMS AND OBJECTIVES 1. To determine the prevalence of thyroid dysfunction in postpartum period. 2. To see the prevalence of TPOab in the postpartum thyroiditis. 3. Percentage of recovery normal thyroid function after postpartum period. MATERIAL AND METHOD This study was carried out in the Department of Medicine and Obstetrics and Gynaecology Department of L.L.R.M Medical College, Meerut, from May 2013 to May 2014; 100 women of postpartum period was selected from OPD and Wards and subjected to a protocol which include history specially palpitation, depression, fatigue, sweating, constipation and examination with a special reference to general body built, height, weight, pulse, BP, respiratory rate, pallor, cyanosis, icterus, oedema, lymphadenopathy, body temperature, eyes signs, hairs and skin changes and BMR were noted. All the system were examined thoroughly. Thyroid gland was examined thoroughly. All the women are subjected to following investigation. A complete haemogram T3, T4, TSH, TPO antibodies and blood sugar (Fasting and PP). All were followed at 6 weeks and 6 months with above protocol. RESULT The study groups consist of 100 women of post-partum period, (06 weeks to 06 months) with no previous history of thyroid disorder. All subjects were randomly selected. Most of the women were between age group of 20 to 25 years of age, approximately 45% of the study group. Most of the women were parity of (1-2) and (2-3). Out of 100 women, 11 women showed postpartum thyroid dysfunction (Approximately 11%); 06 women were hyperthyroid having thyroid value between 21.9-29.0 and TSH between 0.005-0.350. Two women show subclinical hypothyroidism (Normal T3, T4 and high TSH). Three women were hypothyroid (Decrease T3 and T4, increase TSH). All women were followed with OPD, phone and home visit at 6 months. Out of 11 women who were previously showing postpartum thyroid dysfunction, one women showed complete recovery which was previously hyperthyroid. Out of 6 hyperthyroid 2 became hypo, 1 became euthyroid and 3 remained hyper at 6 months. Out of 5 hypothyroid, 1 became euthyroid, 4 remained hypothyroid. Thus at the end of study, approximately 9% women were having thyroid dysfunction. In this study, 8 women were having positive TPOAb, in which 5 women were showing thyroid dysfunction and 3 women who were positive did not show postpartum thyroid dysfunction. Thus in TPOAb positive women prevalence was app. 62%. In this study 4 women were having gestational diabetes, out of which 1 woman also had postpartum thyroid dysfunction. There is also increase in depressive symptoms in this group (TPOAb positive). CONCLUSION Postpartum thyroiditis is significantly present in women of postpartum period,...