الفهرس 
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Abstract
Pregnancy is a physiological condition for women with varieties of new biochemical and metabolically changes. The evaluation of thyroid function test during pregnancy and particularly in the first- trimester of pregnancy is of great importance due to extra requirement of thyroxin for growing fetus particularly physical, mental and brain developments.
Thyroid dysfunctions considered one of the most serious disorders and it might go unnoticed as nonspecific problem which have a strong relationships with pregnancy complications as intrauterine deaths, spontaneous abortion, premature births and pre-eclampsia, as well as major malformations and decrease in IQ.
The aim of this work is the determination of the thyroid function tests during the first trimester of pregnancy and particularly the reference interval for thyroid function tests for pregnant women to prevent mis-diagnosis and irreversible mental and physical adverse affect for growing fetus.
The blood samples well collected to evaluate thyroid function to diagnose either hyperthyroidism or hypothyroidism by determination of Tri-iodothyronine (T3), Thyroxin (T4), thyroid stimulating hormone (TSH) and Human chorionic gonadotropin (HCG).
The study evaluates thyroid functions in one hundred women in their first trimester of pregnancy. This study included 100 pregnant women. Their age ranged from 18-40 years old. The duration of pregnancy at time sampling was 4-12 weeks, with gestation number (1-4 pregnancies) and parity number (0-4 labors).
Using the Endocrine Society Clinical Practice guidelines, these women were classified as 85 non-risk patients and 15 pregnant women as risk patients who had a personal or family history of thyroid disease, a personal history of diabetes or other autoimmune disease, a history of miscarriage, preterm delivery and infertility as risk incidence to develop thyroid dysfunction.
Three women (3.0%) had personal history of thyroid disorders, which included hypothyroidism, hyperthyroidism, goiter, thyroid nodule, and other thyroid disorders, 5.0% had family history of thyroid disorders. 1.0% had history of other autoimmune diseases as diabetes millets type I, 6.0% had history of either miscarriage or preterm labor and 3.0% had history of infertility treatment.
The prevalence of thyroid dysfunction among 100 pregnant women was 31%. 10% had elevated TSH levels (subclinical hypothyroidism), 6% had elevated TSH levels and low TT4 while 3% had elevated TSH levels, low TT3 and TT4 and the remaining 12 % pregnant women had normal TSH with low TT3 and TT4.
The prevalence of thyroid dysfunction in the risk group of thyroid disease was 53.3% which was significantly higher compared to non risk group (27.0%). Also, women with elevated TSH showed significant higher distribution in risk women than in non risk women (33.3% vs 16.5%).
Out of 100 women, 10 % women were diagnosed to have sub-clinical hypothy¬roidism at the pregnancy cut-off levels. 9 % women were diagnosed to have hypothy¬roidism at the pregnancy cut-off levels and in the higher general diagnostic cut-off points the prevalence dropped to 1%. None of the pregnant women suf¬fered overt hypothyroidism.
Our results showed that risk women had more than a 1.9-fold increased risk of thyroid dysfunction during early pregnancy than did women in the non-risk group. Also, the risk women had more than two folds increased risk of hypothyroidism during early pregnancy compared to non risk women.
Case-finding strategy using risk women which confirmed to be more risk to develop thyroid dysfunctions for screening thyroid functions would miss significant percentage of pregnant women with no risk for thyroid dysfunction. Also, using reference intervals of thyroid hormone for pregnant women should be determined to prevent misdiagnosis.
The mean level of β-hCG was significantly lower in women with elevated TSH than in women with normal TSH level.