Keywords : Pregnancy


Thyroid Dysfunction during Pregnancy

Ula Salah Jumaa; Zahraa Abdulaali Mohammad Hassan

Kerbala Journal of Medicine, Volume 11, Issue 1, Pages 3894-3902

background: Pregnancy is the time of hormonal changes which may result in endocrine disorders. Thyroid disorders are common clinical problem during pregnancy in which subclinical hypothyroidism is the most common thyroid disorders. Maternal thyroid dysfunction may result in short-term and long- term harm to the mother and child.
Objective: To study the prevalence of thyroid disorder during pregnancy and to follow the correlation between (TSH, FT3, and FT4) with BMI
Materials and Method: A cross sectional study involved 120 pregnant women in second and third trimester (apparently normal) between (19-42) years.
The participants were collected randomly from outpatient unit of Al-Zahraa teaching hospital in AL-Najaf AL-Ashraf, detailed history and data for pregnant women were recorded (including maternal age, gestational age ,medical history of thyroid disease and history of abortion and infertility) .Pregnant women with history of thyroid disease were excluded from the study. Serum TSH, FT3 and FT4 were measured for all pregnant women participated in study
Results: The prevalence of thyroid disorder during pregnancy was 20.8% out of which 20(16.6%) had SCH and 2(1.6%) had OH. Hyperthyroidism detected in 3(2.5%) pregnant women all of them had subclinical hyperthyroidism. and there was a positive correlation between TSH, FT3 with BMI and negative correlation of FT4 with BMI, also maternal age don’t affect thyroid function status significantly (p value < 0.05).and there was no significant relation between thyroid disorder and history of abortion or infertility (p value < 0.05)
Conclusion
There is a high prevalence of hypothyroidism during pregnancy and the majority is subclinical hypothyroidism .BMI was correlated positively with TSH and FT3 and negatively with FT4.

Morphological Study of the mice’s Islets of Langerhans and β-cells mass assessment during Pregnancy and lactation conditions

May F. Al-Habib; Hayder H. Abdulameer; Ahmad H Abood

Kerbala Journal of Medicine, Volume 9, Issue 2, Pages 2523-2533

b
ackground: Islets of langerhans adapts to changing insulin demands in the body. One of the most amazing reversible islets of langerhansadaptations occurs during pregnancy and postpartum conditions. During pregnancy,β-cells mass expand by increasing their number and size . and they are rapidly reversed at end of pregnancy by β- cell apoptosis and retained to normal level .
Objectives: This study attempt to demonstrate the changes of the islets of langerhans that happen during pregnancy and lactation including changes in the general morphological and histological features, changes in the certain islets’ parameters e.g. number ,diameter and mean areas, and changes in the β – cells mass.
Material and Methods: We were used thirty female mice which divided into (3) groups ten for each group. Group(A): served as a control. Group(B) was pregnant group (at day 15 of gestation). Group(C) was lactating group (at day 4 of Postpartum). Tissues were processed for both paraffin block and semithin plastic sections . Tissue sections were stained with H&E stain, Gomoritri chrome stain and NDS. Two digital image analysing soft wares were used in this study: Image J program and Image Scope program
Results: It was demonstrated that the formation of new islets, enlargement of islets by union of adjacent small islets and by increased their cellularity were common features of pregnant group. also it was showed that in postpartum group, apoptosis of beta -cells started to restore the beta- cell number to normal level. The morphometric analysis of the islets parameters in this study showed a highly significant differences among the studied groups with P value ≤ 0.001. The mean number , mean diameter and mean area of islets were significantly higher in pregnant group, intermediate in lactating group and lowest in control group. In this study, the result also showed that the β-cell mass rose near the doubled during pregnancy as compared with control group, then decreased by 25% at 4th day of postpartum. This study conclude that islets of langerhans subjected to natural compensatory changes during pregnancy then they retain to normal state when pregnancy ended

Clinical Significance of High First Trimester C- reactive Protein in Prediction for Development of Gestational Diabetes Mellitus

Saba M. Swadi AL-Thweeni

Kerbala Journal of Medicine, Volume 9, Issue 2, Pages 2599-2606

b
ackground: GDM is glucose intolerance with onset or first recognition during pregnancy, it has been associated with not only acute increased risk for complications of pregnancy but also long-term disease risks for both mother and baby due to inflammation that plays a key role in the pathogenesis of GDM. The need of a reliable early test to diagnose and predict GDM earlier is important for development of useful intervention therapies that may impact not only on the acute but long-term health outcomes.
Objective: We performed this survey to investigate the predictive value of the of first-trimester serum CRP as screening test of gestational diabetes mellitus and, to evaluate the correlation between high CRP and body mass index (BMI).
Patients and Methods: A prospective cohort study design was conducted in AL -Qadisia City in Iraq from January 2012 to January 2015. Data for the study was collected from patients attending the department of Obstetrics and Gynaecology ,outpatient and private clinic. It included 110 low risk pregnant women at first trimester(8-13 weeks). Study was included after meeting inclusion and exclusion criteria. Venous blood was screened for plasmatic C reactive protein by CLIA system to measure C reactive protein in values with cut- off point of high level more than 3mg/L , fasting blood sugar by photometric method and in addition to routine antenatal tests. They were followed up to delivery by continue to measure fasting blood sugar between 24-28 week and after 28 week of gestation . Also for assessing of complications (10 women were lost to follow ,so only 100 women were finally available).
Results: In total, 100 low risk pregnant women at first trimester with high CRP(>3mgL), (mean+SD 5.33+1.61), 88% of them developed GDM, 53women developed between 24-28week(early GDM, group1),35women developed >28 week(late GDM ,group2),while 12 of them remain normal(group3). CRP was significantly high in group1 comparing to group2 and group3 ( mean+SD 6.383+ 1.439 , p< 0.001). BMI was also significantly high in group1 comparing to group2 and group3 (100% versus14.8%). Maternal and fetal complications were significantly less frequent in women with group1 than group2 (1.88%, 11.32% and 17.14%, 28.57%) (p=0.010, 0.040) respectively.
Conclusions: We did find a significant correlation between high maternal serum CRP level at first trimester and subsequent development of gestational diabetes and also, our study showed a significant correlation between pre-pregnancy BMI and CRP in early gestational diabetic women

Prevalence of Asymptomatic Urinary Tract Infections in Pregnant Women at Al-Abbasiah Primary Health Care Center in Kerbala

Riyadh Dhayhood Al-Zubaidi

Kerbala Journal of Medicine, Volume 8, Issue 2, Pages 2297-2300

background: Asymptomatic urinary tract infection (UTI) during pregnancy may progress to pyelonephritis. Urinary tract infection increase risk of preterm labor and premature rupture of the membranes, and low-birth-weight infants.
Aim: To estimate prevalence of asymptomatic urinary tract infection during pregnancy
Method: A cross-sectional study was conducted in a total of 200 women (hundred pregnant women and hundred non-pregnant mothers) with no signs and symptoms of urinary tract infection, from 1st of January to 28th May of 2013. Mid-stream urine samples were collected from all participants and examined directly under high power field, Pus cells > 5 / HPF indicate the presence of infection .
Result: forty eight of the pregnant (48%) and twenty (20%) of the non-pregnant had UTI which was statistically very significant (p value ˂ 0.005). Also, there was a significant statistical relation between the UTI and the educational level (p value ˂ 0.05), but there was negative relation with the age (p value > 0.05).
Conclusion: there is a high prevalence of asymptomatic urinary tract infections in pregnant and non-pregnant women irrespective of their age or educational level of them

Hypertension and Pregnancy in Karbala Maternity Hospital

Muna Kasim Mahmood

Kerbala Journal of Medicine, Volume 6, Issue 2, Pages 1625-1629

background: Hypertension complicates 5-7% of all pregnancies. Preeclampsia
characterized by development of hypertension, proteinuria and multisystem
involvement after 20 weeks of pregnancy in a previously normal female and
disappear after peurperium and it is responsible for substantial maternal and fetal morbidity.
Objective: the purpose of this study was to know the complications of hypertension in
female during pregnancy and postpartum period, the method of termination of pregnancy,
fetal and neonatal outcome of female with hypertension in pregnancy.
Methods: this is a prospective study involve 75 pregnant women with hypertension admitted
to Karbala maternity hospital, we monitored their pregnancies and recorded the development
of complications.
Results: eclampsia developed in 25.33% of them, HEELP syndrome developed in 9.33% and
intrauterine fetal death occur in 6.66% and no maternal mortality occurring during this
period, intrauterine fetal death occur in 6.66% of them and 32% of them delivered vaginally.
Conclusion: lower incidence of eclampsia, maternal death, intrauterine fetal death and other
complications due to preeclampsia due to good monitoring and the use of prophylactic
magnesium sulphate in severe cases.

Thyroid Role in Threatened Abortion

Thura jaafar kadhum

Kerbala Journal of Medicine, Volume 2, Issue 5, Pages 568-575

Background: Mild impairment of thyroid function may contribute to disturbed reproductive function. Objective: To evaluate the role of thyroid hormones in maintaining early pregnancy and their association with the outcome of the threatened abortion.Materials and methods: The study was carried out in Maternity and pediatric Teaching Hospital in Al-Najaf during period between 1st April to 1st September 2008. The study included 80 pregnant women divided into two groups 50 women with threatened abortion and 30 women with normal pregnancy of comparable age, parity, gestational age and body mass index (BMI). Both groups were subjected to clinical examination, obstetric ultrasound examination and were investigated for hemoglobin, total thyroxine (TT4), total tri-iodothyronine (TT3) and thyroid stimulating hormone (TSH). The group of threatened abortion women divided into two groups where 31 women had a positive outcome (continuation of pregnancy to the third trimester) and 19 women had a negative outcome (pregnancy ended with spontaneous abortion). Results: There was a significant difference in the level of TT3 and TSH between the control group and the women with threatened abortion (lower TT3 and higher TSH in threatened abortion women) with no significant difference in TT4 between the two groups while TT3and TT4 levels were significantly reduced in the women with negative outcome as compared with the women with a positive outcome while the TSH level was significantly increased in the women with negative outcome. Conclusion: reduced levels of thyroid hormones in early pregnancy may contribute to some cases of spontaneous abortion.Key words: thyroid hormones, pregnancy, abortion.