Malpresention is any presentation other than the vertex, breech presentation at term is the most common abnormal fetal presentation and is associated with neonatal and maternal morbidity and mortality. Many etiological factors associated with malpresention including prematurity, intrauterine growth restriction; uterine and pelvic abnormality and endocrine diseases as in hypo – or hyperthyroidism which impair obstetrical outcome.
Objectives: To study and evaluate the relationship of disturbed maternal thyroid function during gestation and abnormal fetal presentation at term.
Patients and methods: Prospective randomized study of pregnant women
Over nine months period from October 2013 to July 2014 A hundred healthy pregnant women who living in Tikrit and Al-Fallujah cities with age ranging from 19 – 45 years old (mean age of 28.5) randomized selected undergone history and clinical examination, obstetrical ultrasonic examination done for them with blood sample taken at term(37 gestational week and more) for thyroid function assessment through free thyroxin T3, bound thyroxin T4, thyroid stimulating hormone TSH.
Result: A fifty pregnant women were cephalic presentation (50%), thirty five were breech (35%) and other presentations such as shoulder, face, brow were 10%, 4% and 1% respectively. Normal thyroid function through thyroid parameters was shown in (83%) of the pregnant (class I), (8%) of cases were associated with hyperthyroxinaemia (class II) and (9%) were hypothyroxinaemia (class III); 2 cases of cephalic presentation (2%) of total cases; 6 cases of breech (6%) of total cases and one case of shoulder presentation (1%) of total cases were hypothyroxinaemia, 4 cases of cephalic presentation (4%), 3 cases of breech (3%) and one case (1%) face presentation were (class II) Hyper thyroxinaemia).
Conclusion: Pregnant women with abnormal thyroid function during gestation are at risk of fetal malpresentation. Hypothyroxinaemic pregnant showing high incidence of breech presentation with more incidence of caesarean section and more fetal, maternal and obstetrical complications.