الفهرس 
hyroid physiology and function in normal pregnancyOnly 14 pages are availabe for public view
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Abstract
Pregnancy has pronounced effect on thyroid physiology ,total
concentration of triiodothyronine (T3) and thyroxine (T4), increase during
pregnancy because of elevated thyroid hormone binding globulin (TBG), serum
human chorionic gonadotropin (hCG) during pregnancy, Thus, the serum TSH
concentration is low in the first trimester and increase significantly in the second
trimester and third trimester. Thus, the use of trimester-specific recommendations
for thyroid hormone reference ranges is essential for accurate diagnosis of thyroid
dysfunction.
In this work, a cohort, prospective study, include one hundred and twenty
three healthy pregnant female recruited from antenatal care at department of
Obstetrics and Gynecology at Menofia Univeristy Hospital and Damas Central
Hospital after obtaining an approval of Medical Ethics Committee for Human
Research.
All Participants Were Subjected To
History taking including (Personal history, Past history, Menstrual history,
Obstetric history). General examination blood pressure, pulse and temperature
together with presence of abnormal complexion as pallor, jaundice or cyanosis.
Abdominal examination as F.H.S.
Maternal serum samples collected in early pregnancy (range 9–18 weeks).
Plain tubes centrifuged and serum was stored. TSH and FT4 concentrations in
maternal serum samples determined using chemiluminescence assays.
Measurements of placental vascular resistance used as a reflection of
placental function and measure of the placentation success. Placental vascular
resistance evaluated with recorded flow-velocity waveforms from the umbilical
(representing the fetal vascular compartment) and uterine (representing the
maternal vascular compartment) arteries in the second trimester and third
trimester. using (Toshiba) ultrasound machine made in Japan at Damass central
Hospital. The ultrasound machines with Doppler unit and a convex transducer (3-
5 MHz).
Results
Our data show an association of early gestational thyroid function with
measures of placental vascular function in later pregnancy.
Higher maternal FT4 concentration during early pregnancy was associated
with higher placental vascular resistance in the second trimester and the third
trimester.
Higher FT4 was associated with placental outcomes in the third trimester,
namely a higher umbilical PI and uterine RI.
There was significant positive correlation between FT4 and PI& RI while
there was negative correlation with TSH.
Regarding pre-eclampsia and LBW, they were significantly higher among
high normal group
There was increase in fetal complication associated with higher FT4
IUGR, respiratory distress and intensive care entry but not statistically significant
That there was significant difference between the studied FT4 hormone
groups regarding APGAR score of the neonates where normal level FT4 group
reported significantly higher APGAR score at 1 and 5 min.