الفهرس | Only 14 pages are availabe for public view |
Abstract Pregnancy has pronounced effect on thyroid physiology ,total concentration of triiodothyronine (T3) and thyroxine (T4), increase during pregnancy because of elevated thyroid hormone binding globulin (TBG), serum human chorionic gonadotropin (hCG) during pregnancy, Thus, the serum TSH concentration is low in the first trimester and increase significantly in the second trimester and third trimester. Thus, the use of trimester-specific recommendations for thyroid hormone reference ranges is essential for accurate diagnosis of thyroid dysfunction. In this work, a cohort, prospective study, include one hundred and twenty three healthy pregnant female recruited from antenatal care at department of Obstetrics and Gynecology at Menofia Univeristy Hospital and Damas Central Hospital after obtaining an approval of Medical Ethics Committee for Human Research. All Participants Were Subjected To History taking including (Personal history, Past history, Menstrual history, Obstetric history). General examination blood pressure, pulse and temperature together with presence of abnormal complexion as pallor, jaundice or cyanosis. Abdominal examination as F.H.S. Maternal serum samples collected in early pregnancy (range 9–18 weeks). Plain tubes centrifuged and serum was stored. TSH and FT4 concentrations in maternal serum samples determined using chemiluminescence assays. Measurements of placental vascular resistance used as a reflection of placental function and measure of the placentation success. Placental vascular resistance evaluated with recorded flow-velocity waveforms from the umbilical (representing the fetal vascular compartment) and uterine (representing the maternal vascular compartment) arteries in the second trimester and third trimester. using (Toshiba) ultrasound machine made in Japan at Damass central Hospital. The ultrasound machines with Doppler unit and a convex transducer (3- 5 MHz). Results Our data show an association of early gestational thyroid function with measures of placental vascular function in later pregnancy. Higher maternal FT4 concentration during early pregnancy was associated with higher placental vascular resistance in the second trimester and the third trimester. Higher FT4 was associated with placental outcomes in the third trimester, namely a higher umbilical PI and uterine RI. There was significant positive correlation between FT4 and PI& RI while there was negative correlation with TSH. Regarding pre-eclampsia and LBW, they were significantly higher among high normal group There was increase in fetal complication associated with higher FT4 IUGR, respiratory distress and intensive care entry but not statistically significant That there was significant difference between the studied FT4 hormone groups regarding APGAR score of the neonates where normal level FT4 group reported significantly higher APGAR score at 1 and 5 min. |