The use of thyroid stimulating hormone testing in pregnancy and post-partum at Rahima Moosa Mother and Child Hospital

Abstract

Background: Thyroid disease is an uncommon but important cause of pregnancy and postpartum complications. Early diagnosis aids in preventing these complications. This study aimed to review the indications for TSH testing during pregnancy and evaluate the results and pregnancy outcomes of those tested at the Rahima Moosa Mother and Child Hospital. Methods: This retrospective descriptive study was conducted at Rahima Moosa Mother and Child Hospital in Coronationville, Johannesburg. Medical records of pregnant women and women in the postpartum period who had their TSH tested between the 01st October and 31st December 2019 were retrieved and reviewed. The indication for investigating a TSH level, the TSH result, and pregnancy outcomes were evaluated. Results: A total of 746 TSH samples were collected during the study period. Out of these, only 122 files were found and retrieved from the records department and reviewed. Only 82 (67.2%) of the patients had indications in line with American Thyroid Association (ATA) recommendations. Data showed that 106 (86.9%) of patients were euthyroid, 11 (9.0%) hypothyroid, and five (4.1%) were hyperthyroid. There was one low birth-weight baby born to a patient with hyperthyroidism, one low birth-weight baby, and one intrauterine fetal demise born to a patient with hypothyroidism. There were no maternal complications in patients found to be hyperthyroid, and only one pregnancy was complicated by sepsis in those patients found to be hypothyroid. Conclusion: Thyroid disease screening during pregnancy and postpartum at Rahima Moosa Mother and Child Hospital did not adhere to ATA recommendations. This study has a higher prevalence of thyroid disease than the world-reported prevalence.