Pk Shah

Principles and Practice of Obstetrics and Gynecology for Postgraduates

In civilized society, citizen is governed by number of laws of the land. Numbers of laws are directly proportional to the state of civilization. India is not an exception. Acts which are applicable mainly to the obstetrician and gynecologist, such as Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act, Consumer Protection Act (CPA), criminal laws and Biomedical Waste (BMW), are discussed. Labor laws are just mentioned. The application of certain Acts may vary from state to state as few Acts are central and few are state Acts. Certain rules under the Act may be different in some states.

To study and compare the obstetric and neonatal outcome of pregnancies complicated with hypothyroidism amongst antenatally detected and treated hypothyroid patients and patients found to be hypothyroid at the time of labor

Background: To evaluate pregnancy outcome in women with elevated serum thyroid stimulating hormone (TSH) values as compared to those in whom hypothyroidism was treated. Methods: A prospective interventional comparative study was conducted in the department of obstetrics and gynaecology in King Edward Memorial Hospital, Mumbai, India from 2014 to 2015. A cohort of 60 hypothyroid patients was divided into two groups of 30 each. Group 1, euthyroid (treated hypothyroid) and group 2, hypothyroid at the time of labor and pregnancy outcomes were compared. Results: All patients in group 1 delivered at term; whereas in group 2, 9 (30%) patients had preterm deliveries and 21 (70%) delivered at term, amongst which 5 patients delivered babies with severe intrauterine growth restriction (IUGR). Neonatal intensive-care unit (NICU) admission were required for 3 neonates in group 1 and 11 (36.67%) neonates in group 2. Group 1 delivered 5 (16.67%) low birth weight babies (weight <2.5 kg) whereas 16 (53.34%) babies had low birth weight in group 2. Conclusions: Treatment of patients diagnosed with hypothyroidism during pregnancy significantly (p value <0.05) reduced the risk of preterm labor, low birth weight, need for NICU admission.