Category: Thyroid

Diagnosis and management of subclinical hypothyroidism in pregnancy: Retrospective Review Study

Monday, Apr 8
1:00 AM – 2:00 AM

Objective :

     The aim of this study is to clarify the world wide variation in prevalence of SCH, the accurate methods been used for diagnosing (SCH) in pregnant women, main adverse pregnancy outcomes related to (SCH) and the clinical impact of levothyroxine on gestational SCH related complications .


Methods :

        Meta-analysis of the results of all studies that were investigated the screening methods, adverse pregnancy outcomes and the treatment of SCH during pregnancy which were published in English language during the last two decade including the popular guidelines in this regard.


Results :

      


The studies revealed a strong linear association between preterm delivery, miscarriage and TSH level with more events, if combined with positive thyroid antibodies. The difference in TSH (TSR) ranges among different ethnicity and countries should be considered for diagnosis and treatment.


Discussion :

        There is a strong relationship between segregated positive TPO antibodies or (TgAb) and a higher serum TSH contrasted with women without thyroid antibodies. The high TSH and TPO antibodies have been related with increment preterm birth and higher abortion .It is essential to have new optimal cut-off values of gestational TSH according to the geographical distribution and ethnicity to avoid over estimate or underestimate diagnosis of SCH. Levothyroxine treatment of SCH during pregnancy is safe and  cost-effective and finally, universal screening should be considered for region with high prevalence of SCH as several studies showed significant number of SCH were missed, if considering the high risk case targeting rather than universal screening.


 


Conclusion :

     


     There is a significant variation in the prevalence of SCH during pregnancy in all over the world based upon the age, ethnicity and other regional factors. Numerous nations do not have their own populace – based TSR and extraordinary change will happen with critical more number of SCH will be analysed if a universal screening was utilized .Most studies have demonstrated  the relationship among SCH in pregnancy, abortion and preterm deliveries. . Screening should be done, once pregnancy is confirmed in women with risk factors, using trimester-specific TSH ranges.  Universal screening should be considered for region with high prevalence of SCH as several studies showed significant number of SCH were missed, if considering the high risk case targeting .This systematic review study demonstrated that thyroid hormone treatment for SCH during pregnancy, is cost effective and safe to diminish preterm delivery and pregnancy loss.

SHORT URL FUNCTION-->

Ala HOSSEIN.. Mortadha

Consultant physician
Arabic
Fujairah, United Arab Emirates

CV


Name Ala Hossein Mortadha Alshami
Address of work Fujairah hospital
P.o box 2160 - Fujairah – UAE
Tel 971-9-2242999 ext.: 690, 650, and 315
Mobile 0505206883
Fax 971- 9 -2242030
Email; alaamurtatha@hotmail.com
Nationality CANADIAN
Marital status married with 5 children
DOB 06/10/1961
Language Arabic & English
Employment Type: Government Hospital
Job Title Senior Consultant Physician and Endocrinologist
Institution MOH - Fujairah Hospital

Education
 FCCP – USA
 FRCP – UK
 MRCP – UK - internal medicine
 Diploma -Endocrinology –south wales University _UK
 MSc –Endocrinology- south wales University _UK
 MDICP (Univ. of Medical College of Baghdad-Iraq)
 DPM (Univ. of Medical college of Baghdad– Iraq)
 MBChB (medical College of Baghdad University)

Postgraduate Education and Training:
 Internship (Alkarama Teaching Hospital) 1985-1986
 SHO (kadhymia Teaching Hospital) 1987- 1989
 Fellowship of diploma of Iraqi Board of Medicine (kadhymia Teaching Hospital (Univ. Of Baghdad) 1989- 1993
 MCCEE: (Toronto - Canada 2003)
 MCCQE (Toronto - Canada 2004)
 Training of Trainer of FRACGP PROGRAM (ROYAL COLLEGE OF GENERAL PRACTITIONERS) (Australia) 2008

Post graduate Certifications
 DIPLOMA OF IRAQI BOARD OF MEDICINE – 1993
 MRCP (UK) IN INTERNAL MEDICINE – 2000
 MMCC (CANADA) -2004
 FELLOWSHIP OF ROYAL COLLEGE OF PHYSICIANS IN INTERNAL MEDICINE (Glasgow- UK) 2007
 FELLOWSHIP OF AMERICAN COLLEGE OF CHEST PHYSICIANS (USA) 2011
 DIPLOMA with distinction -Endocrinology - south wales University _UK
 MSc with distinction –Endocrinology- south wales University _UK

Specialties
 Internal medicine AND Endocrinology
Professional Associations:
 Associate professor in internal medicine – Medical college of RAK
 Fellowship of Medical council of Iraqi Board of medicine
 Fellowship of Royal College of Physicians (UK) (ID no 45227)
 Fellowship of American College of Chest Physician (ID no 313396)
 Member of American association of clinical endocrinology (AACE)

Medical Licensures
Senior Consultant Physician and Endocrinologist (Evaluation of MOH – UAE: Consultant A)

Clinical experience and work:

(Senior consultant Physician and endocrinologist - Fujairah Hospital from 1997-2018:
• Lecturer and Clinical sessions in Internal Medicine and Endocrinology for students (4th and final year) of RAK Medical college
• Diabetic and hypertension (management and treatment of its complications)
• Management of metabolic syndrome and its complications
• Pre and postoperative assessment of patients
• Examiner and re-evaluation for MOH doctors
• Attending and Participating as speaker and chairman in national and international conferences for ( Endocrine with special interest in thyroid disorders , diabetes; respiratory and Internal medicines
• Responsible for managing COPD and asthmatic diseases
• Head of Infection Control Committee – Fujairah Hospital
• Member of CME committee – Fujairah Hospital
• Member of JCI committee – Fujairah Hospital

1995-1997(Senior Specialist in internal medicine - family medical center –Amman-Jordan) :
• Management of cases internal medicine
• Management of chronic and communicable respiratory diseases
• Medical advice to improve the health services
• Medical consultations
• Critical care medicine opinion

1993-1995 ( Senior Specialist in internal medicine in Kadhmia Teaching hospital) (Baghdad)
• Lecturer and clinical sessions for postgraduate diploma doctors in internal medicine
• Management of infectious disease ,chronic diseases (respiratory, hypertension ,diabetes , cardiovascular ,and its complications
• Participating in conferences and medical meeting
• Participating in clinical researches

Honors And Awards :
1- Award of distinguished Dr. in internal medicines 2010 –Fujairah Hospital
2- Certificate of appreciation from MOH-Fujairah for active participate in CME
3- Certificate of appreciation for active participate as speaker from Red Crescent of Fujairah 2013
4- Certificates of attending more than 100 national and international conferences in Diabetes and Endocrinology with regular participating in Gulf Chapter of AACE in UAE.

Research and publications:

1- Clinical significance of plasma fibrinogen level in acute myocardial infarction (Evaluated as original & published in ( The practitioner) 1996
2- IDMPS - 3rd Wave ( International Diabetes Management Practices Study ) Participate as investigator with sanofi – Aventis 2008
3- 5A STUDY (Awareness of Abdominal Adiposity As A marker of cardio-metabolic risk) Participate as investigator with sanofi –Aventis 2009
4- IDMPS - 4th Wave ( International Diabetes Management Practices Study ) Participate as investigator with sanofi –Aventis 2010
5- IDMPS - 5th wave ( International Diabetes Management Practices Study) Participate as investigator with Sanofi –Aventis 2011
6- Diagnosis and management of Subacute Hypothyroidism during pregnancy : Retrospective Review Study -2018