Assessment of Thyroid Gland Enlargement Through Clinical Grading and its Correlation with Ultrasonographic Thyroid Volume among Pregnant and Non-Pregnant Women in Local Population in Karachi
Thyroid Enlargement and Ultrasonographic Assessment
Abstract
Objectives: The aims of this study were to evaluate thyroid gland enlargement using clinical grading methods
in both groups, measure thyroid volume through ultrasonography, and determine the correlation between
clinical grading and ultrasonographic thyroid volume.
Methodology: This cross sectional study was conducted at the Gynea OPD, Ojha campus, DIMC, DUHS,
Karachi from Oct 2016-Dec 2018) through consecutive sampling and separated into two groups, Pregnant
and Non Pregnant women. The gross examination of thyroid gland was performed and this examination
purpose to evaluate the size of thyroid lobes through standard methods of inspection and palpation. The
Thyroid volume was measured by ultrasound and then calculated by WHO co-factor V (ml) =0.479*L*W*D
by applying inclusion / exclusion standard.
Results: The examination were made on thyroid grading with correlation of total thyroid volume (TTV)
among pregnant and non-pregnant women. Thyroid gland was examined by inspection and palpation. The
grading (from 0-2) of enlargement of gland was done. 50 pregnant women were examined among which 34
(68%) were found to have Grade 1 while 16 (32%) had no thyroid enlargement (means neither visible nor
palpable). On the other hand, in the non-pregnant group, not even a single enlargement was observed. The
mean difference was considered significant in pregnant women with p-value (< 0.01). In non-pregnant women,
mean TTV was 5.58±2.41, where as in pregnant women, it was 7.02±3.21, which was significantly increased
in pregnant women with p-value 0.01*.
Conclusion: The study proposed that physical clinical examination of thyroid gland is a valuable method, and
it also finds that even pregnant women who looks healthy in this population may still have some degree of iodine deficiency. The volume of the thyroid gland is enhanced during pregnancy, suggesting an iodine deficiency. A combined approach (clinical + imaging) is recommended for accurate diagnosis in antenatal care
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