title: Feto-maternal Outcome Using New Screening Criteria of Serum TSH for Diagnosing Hypothyroidism in Pregnancy.
abstract: BACKGROUND
  Evidence suggests that by using the classical non pregnant reference range for serum TSH (STSH), one might miss hypothyroidism in pregnancy. Therefore, upper normal cut off value of S TSH should be taken as <2.5 mIU/L in the first trimester and <3mIU/L in the second and third trimester. However, two Indian studies have reported higher trimester specific reference ranges in the Indian pregnant women.
  
  
  OBJECTIVE
  To assess the maternal and fetal outcomes using new screening criteria with upper S TSH cut off as >3mIU/L, for diagnosing hypothyroidism in pregnancy.
  
  
  METHODS
  This study was a cross sectional study, carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, in collaboration with the Department of Endocrinology. Pregnant women with ≤ 20 weeks gestation, attending antenatal OPD from December 2010 to January 2012 were included in the study. On the basis of S TSH level, women were divided into Study Group with S TSH level between 3.1 to 6.2 mIU/L, (new range to be studied) and an equal number of age and parity matched Control Group with S TSH levels between 0.4 to 3 mIU/L. The maternal and fetal outcomes were compared between study and control groups.
  
  
  RESULTS
  During the study period, a total of 66 women had S TSH between 3.1-6.2 mIU/L. Maternal and fetal outcomes in both the groups were comparable. There was no difference in the mode of delivery between study and control groups.
  
  
  CONCLUSIONS
  The lower S TSH cut off recommended for diagnosing hypothyroidism in pregnancy may not be applicable to pregnant Indian women.
authors.affiliation: Assistant Professor, Department of Obstetrics & Gynaecology, SAIMS , Indore, India .
authors.forename: Deeksha
authors.initials: D
authors.lastname: Joshi
authors.affiliation: Professor & Consultant, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Rupali
authors.initials: R
authors.lastname: Dewan
authors.affiliation: Assistant Professor, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Rekha
authors.initials: R
authors.lastname: Bharti
authors.affiliation: Reserch Officer, Human Reproductive Research Centre, ICMR & Ex senior resident, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Karishma
authors.initials: K
authors.lastname: Thariani
authors.affiliation: Senior resident, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Aanchal
authors.initials: A
authors.lastname: Sablok
authors.affiliation: Professor & Consultant, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Manjula
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Associate Professor & Head of Endocrinology department, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Krishna
authors.initials: K
authors.lastname: Biswas
authors.affiliation: Ex Head of the Department, Consultant & Professor, Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India .
authors.forename: Aruna
authors.initials: A
authors.lastname: Batra
keywords: Endocrinological disorders; Reference values; Screening in pregnancy; Serum TSH