Authors: Rupali Modak, Amitava Pal, Santanu Bar
The objective of this paper is to evaluate the relation between maternal thyroid profiles with breech presentation at term. Seventy nine antenatal mothers with breech presentation and 79 pregnant mothers with cephalic presentation matched by same age and parity as in breech were prospectively evaluated at term. Thyroid profiles (serum TSH and FT4 levels) of all antenatal mothers (n=158) were assessed at 36 weeks of gestation.: Compared with women having fetuses in cephalic presentation to those pregnant mothers, who presented breech presentation at term had significantly higher concentration of TSH at 36 weeks of gestation (p<0.001). Women with serum TSH <0.817mIU/l (10th percentile) had breech presentation of 12.5%. The prevalence of breech presentation in the subgroup of women with TSH >2.6mIU/l (90th percentile) at 36 weeks of gestation was 85.72% compared with 46.53% in the women with TSH ≤ 2.6 mIU/l. Breech presentation was significantly and independently related to high maternal TSH concentration (>2.6mIU/l) at 36 weeks of gestation (OR= 6.8955; 95% CI: 1.4896-31.9203, z stat: 2.4700; p =0.0135). The relation of breech presentation with serum FT4 >16.4 pmol/l (>90th percentile) at 36 weeks of gestation was not significant (OR=0.3680; 95% CI: 0.1103-1.2276; z stat: 1.626; p =0.1039). Serum FT4 assay during late gestation was less reliable.Women with serum TSH level above 2.6 mIU/L) during the end of gestation are at increased risk for fetal breech presentation.
Serum FT4, TSH, breech, cephalic presentation
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Correlation of Maternal Serum Thyroid Hormone Levels and Breech Presentation at Term