Volume 03 Issue 01-2023
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
03
I
SSUE
01
Pages:
24-29
SJIF
I
MPACT
FACTOR
(2021:
5.
705
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(2022:
5.
705
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OCLC
–
1121105677
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ABSTRACT
The characteristic of the growth rates of various indicators at the stages of screening examination allows us to judge
the adaptation processes occurring in the process of fetal growth. And in fetuses of pregnant women in a state of
hypothyroidism, the intensity of growth of head parameters was less compared with the parameters of fetuses of
healthy pregnant women. In fetuses of pregnant women in a state of hypothyroidism, the biparietal head size is
significantly smaller at the stage of the second screening examination than in fetuses of healthy pregnant women.
KEYWORDS
Hypothyroidism, experimental hypothyroidism, thyroid pathology, thyroid gland, fetal fetometry, prenatal
ontogenesis, hypothyroid pregnant women, fetal anthropometry.
INTRODUCTION
Research Article
FETOMETRY OF THE FETUS
Submission Date:
January 20, 2023,
Accepted Date:
January 25, 2023,
Published Date:
January 30, 2023
Crossref doi:
https://doi.org/10.37547/ajbspi/Volume03Issue01-04
Sagdullayeva Makhmuda Kamalovna
Tashkent Medical Academy, Tashkent, Uzbekistan
Ibragimova Shahzoda Abdurahimovna
Tashkent Medical Academy, Tashkent, Uzbekistan
Tolmasov Ruzibek
Tashkent Medical Academy, Tashkent, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajbspi
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 01-2023
25
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
03
I
SSUE
01
Pages:
24-29
SJIF
I
MPACT
FACTOR
(2021:
5.
705
)
(2022:
5.
705
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The physiological role of thyroid hormones is
extremely great and diverse in all periods of a person's
life, including intrauterine [1]. They regulate and
coordinate the development of the fetus, the
processes of growth and differentiation of tissues,
especially the nervous one [3]. Thyroid hormones
affect almost all metabolic processes, determine
postnatal growth, psychomotor, physical and
intellectual development [2,4]. The functioning of
many organs and systems largely depends on how fully
the child's needs for thyroid hormones are met [3]. An
actively functioning thyroid system determines the
level of the child's general health [5]. A complex of
unfavorable factors, including, first of all, a
complicated course of pregnancy, childbirth, diseases
of newborns lead to a violation of the postnatal
adaptation of the pituitary-thyroid system of
newborns, which manifests itself in the form of a
transient increase in the level of thyroid-stimulating
hormone during the first month of life and is defined as
neonatal transient hypothyroidism [3,7]. The course of
pregnancy in women with various pathologies of the
thyroid gland may be accompanied by intrauterine
growth retardation, low birth weight, and antenatal
death [6]. However, according to the literature, we did
not find information about the anatomometric
features of the fetus at different stages of pregnancy
in women in a state of thyroid insufficiency. An in-
depth study of this issue will make it possible to
develop recommendations for a rational assessment of
fetal development in this category of pregnant
women.
The aim of our study was to study the anthropometric
parameters of the fetus in healthy and pregnant
women in condition of hypothyroidism.
MATERIALS AND RESEARCH METHODS
Mandatory screening tests in the I, II and III trimesters
are performed in accordance with the order of the
Ministry of Health of Uzbekistan of June 2018, PO -
5590 “On improving prenatal diagnostics in the
prevention of hereditary and congenital diseases in
children.” Fetometry data of 25 healthy fetuses and 32
fetuses in condition of hypothyroidism were
determined. Screening studies were conducted
according to the standard at a certain time: the first
screening at 12-13 weeks, the second screening at 22-23
weeks, and screening in 22-23 weeks. The average age
of pregnant women in both groups averaged 33 ± 0.4
years, all pregnant women had singleton pregnancies.
Examination of pregnant women includes a mandatory
three-time screening ultrasound examination: in 10-14
weeks of pregnancy, when the thickness of the collar
space of the fetus is mainly assessed; in 20-24 weeks,
ultrasound is performed to identify malformations and
echographic markers of chromosomal diseases;
ultrasound examination in 32 - 34 weeks is carried out
in order to identify malformations with their late
manifestation, as well as for the purpose of functional
assessment of the state of the fetus. The main purpose
of these studies is to assess the capabilities of the
fetoplacental system in terms of providing appropriate
conditions for the development of pregnancy and its
successful completion.
MAIN PART
The results of the study showed that the biparietal
head diameter in fetuses of healthy pregnant women
at the stages of the first screening examination in 12-13
weeks averaged 22.2 ± 1.3 mm, in fetuses of pregnant
women in a state of hypothyroidism at the stages of
the first screening examination did not differ
significantly, and averaged 20.9 ± 1.4 mm (Fig. 1).
Volume 03 Issue 01-2023
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(ISSN
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VOLUME
03
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Pages:
24-29
SJIF
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705
)
(2022:
5.
705
)
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
In fetuses of healthy pregnant women in 14-15 weeks,
the size of the biparietal indicator averaged 29.5 ± 0.8
mm, in pregnant women in hypothyroidism, this
indicator was less and amounted to 26.2 ± 1.2 mm. The
rate of increase in biparietal diameter indicators from
12 to 15 weeks in fetuses of healthy pregnant women
was 32%, and 25.3% in fetuses of pregnant women in a
state of hypothyroidism. At the time of the second
screening examination, the biparietal diameter of the
fetal head in pregnant women in a state of
hypothyroidism was significantly less in comparison
with the group of fetuses of healthy pregnant women.
The average values of this indicator in fetuses of
healthy pregnant women in 20-21 weeks was 54.2 ± 2.6
mm and in fetuses of pregnant women in
hypothyroidism - 46.8 ± 1.4 mm.
In 22-23 weeks, these indicators averaged 60.3 ± 2.6
mm in fetuses of healthy pregnant women and 51.8 ±
1.9 mm in pregnant women in a state of
hypothyroidism. In 24-25 weeks -67.2 ± 2.6 mm and 59.4
± 1.9 mm, respectively.
Data analyzes have shown that the indicators of the
biparietal diameter of the fetal head in healthy
pregnant women are statistically significantly higher
when compared with the values in pregnant women in
condition of hypothyroidism. However, the growth
rate of this indicator in fetuses of healthy pregnant
women was 23.9% from 20 to 25 weeks, and 26% in
fetuses of pregnant women in a state of
hypothyroidism. Analysis of the data of the third
screening examination shows that the indicators of
biparietal diameter in pregnant fetuses were
statistically significantly lower (p <0.05). During the
third screening examination, the mean values of the
biparietal diameter of the fetal head in healthy
pregnant women were 79.8 ± 1.6 mm (at 30-31 weeks),
82.3 ± 1.5 mm (32-33 weeks) and 87.2 ( 34-35 weeks),
respectively. In fetuses of pregnant women in a state
of hypothyroidism, the average values of this indicator
were 77.5 ± 0.7 mm in 30-31 weeks of gestation, 79.8 ±
1.2 mm in 32-33 weeks, and 84.8 mm in 34-35 weeks ±
0.8 mm respectively lower. Moreover, these indicators
are 2% higher in fetuses of healthy pregnant women. In
fetuses of healthy pregnant women in 12-13 weeks, the
frontal occipital size averaged 27.3 ± 1.3 mm, this
indicator in fetuses in 14-15 weeks was 35.9 ± 1.8 mm.
The analysis of the data showed that the size of the
fetal head of the frontal occipital indicators in pregnant
women in a state of hypothyroidism is less and
averaged 25.3 ± 1.5 mm in 12-13 weeks of gestation and
32.8 ± 0.9 mm in 14-15 weeks. In the data of these
indicators, no significant differences observed (p>
0.05). The rate of increase in the frontal occipital size in
fetuses of healthy pregnant women in the period from
12 to 15 weeks was 31%, in fetuses in a state of
hypothyroidism was 29%. The frontal-occipital size of
the fetal head in healthy pregnant women at the stages
of the second screening examination averaged 65.9 ±
1.1 mm in 20-21 weeks, in 22-23 weeks these indicators
reached an average of 72.8 ± 1.5 mm. In fetuses of
pregnant women in a state of hypothyroidism, the
dimensions of the frontal occipital size were slightly
lower and averaged 60.8 ± 0.9 mm in 20-21 weeks, and
by 22-23 weeks, they were 67.8 ± 1.3 mm. The indicators
of the frontal occipital size of the fetal head in healthy
pregnant women at the stages of the second screening
examination in 24-25 weeks averaged 80.2 ± 1.2 mm, in
fetuses of pregnant women in a state of
hypothyroidism these indicators were statistically
insignificant and amounted to -75.6 ± 1,0 mm, in 22-23
weeks these indicators reached an average of 72.8 ± 1.5
mm.
During the third screening examination, the frontal
occipital size in fetuses of healthy pregnant women in
30-31 weeks averaged 99.2 ± 1.5 mm, in fetuses in
Volume 03 Issue 01-2023
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VOLUME
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Pages:
24-29
SJIF
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705
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(2022:
5.
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)
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
hypothyroidism these indicators were 99.0 ± 0.8 mm.
In 32-33 weeks, the average values of the frontal
occipital size of the fetal head were 104.9 ± 0.9 mm in
healthy pregnant women, and 102.9 ± 1.3 mm in
pregnant women in conditions of hypothyroidism. In
34-35 weeks, these indicators in fetuses of healthy
pregnant women were 108.6 ± 1.5 mm, in the group of
healthy pregnant women, 108.1 ± 1.1 mm. When
comparing both groups, no statistical differences were
found. At the time of the third screening examination,
the growth rate of the frontal occipital size from 30 to
35 weeks in the group in fetuses of healthy pregnant
women was 9.4%, and in fetuses of pregnant women in
a state of hypothyroidism - 9.1%.
Another criterion for assessing the development of the
fetal skull is the size of the head circumference. The
size of this indicator does not depend on the shape of
the fetal head. In terms of 12-13 and 14-15 weeks (the
period of the first screening examination), the average
value of this indicator in fetuses of healthy pregnant
women was 75.5 ± 1.4 mm and 100.3 ± 0.5 mm,
respectively, and in fetuses in a state hypothyroidism
73.2 ± 1.1 mm and 96.9 ± 1.4 mm .
There were no statistically significant differences in
these values in the compared groups (p> 0.05). The
growth rate of head circumference in fetuses of
healthy pregnant women was 32.8%, and in fetuses
with hypothyroidism - 32.3%.
At the stage of the second screening examination in
fetuses of healthy pregnant women in 20-21 weeks, the
average head circumference reached 181.8 ± 1.8 mm,
199.3 ± 3.1 mm in 22-23 weeks and 220.0 ± 2, 7 mm in a
period of 24-25 weeks. The average head
circumference in fetuses with hypothyroidism at this
stage of the survey was 177.5 ± 1.8 mm; 190.1 ± 2.5 mm
and 215.3 ± 3.1 mm, respectively. The rate of increase in
the size of the head circumference from 20 to 25 weeks
in fetuses of healthy pregnant women was 21%, and in
fetuses in a state of hypothyroidism 21.2%. At the stage
of the third screening examination in 30-31 weeks in
fetuses in a state of hypothyroidism, the head
circumference was 280.2 ± 2.4 mm, in 32-33 weeks -
294.5 ± 2.1 mm, in 34-35 weeks - 305.9 ± 2.4 mm.
In fetuses of healthy pregnant women, the head
circumference was 281.4 ± 2.1 mm; 297.6 ± 2.5 mm and
312.4 ± 3.9 mm, respectively. The growth rate of the
head circumference from 30 to 35 weeks in fetuses of
healthy pregnant women was 11%, and in fetuses of
pregnant women in a state of hypothyroidism - 9.1%.
There were no statistically significant differences in
these values in the compared groups (p> 0.05).
RESULTS AND DISCUSSIONS
The characteristic of the growth rates of various
indicators at the stages of screening examination
allows us to judge the adaptation processes occurring
in the process of fetal growth. Analysis of our data
shows that the period from 16 to 20 weeks (the stages
between the first and second screening examinations)
is the highest rate of increase in head size. At the same
time, in fetuses of healthy pregnant women, the rate
of increase in biparietal diameter was 83.7%, frontal-
occipital size - 83.5%, head circumference - 81.2%.
In fetuses of pregnant women in a state of
hypothyroidism, the intensity of the growth of head
parameters was less in comparison with the
parameters of fetuses of healthy pregnant women.
Thus, the biparietal head diameter in pregnant fetuses
in a state of hypothyroidism for the period from 16 to
20 weeks of intrauterine development increased by
78.6%, the frontal-occipital size by 85.3%, and the head
circumference by 75.7%.
Volume 03 Issue 01-2023
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Pages:
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SJIF
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)
(2022:
5.
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
The increase in the parameters of the head of the
fetuses of both groups from 21 to 25 weeks slowed
down by 2 times. At the same time, indicators of
biparietal head diameter in healthy pregnant women
increased by 23.9%, parameters of frontal occipital
head size by 21.6%, head circumference by 34.8%. These
indicators in fetuses of pregnant women in a state of
hypothyroidism had similar values to those in fetuses
of healthy pregnant women, the biparietal diameter
increased by 26.9%, the frontal-occipital size by 24.3%,
the head circumference by 26.4%.
In the periods between the second and third screening
examinations (26-30 weeks), the intensity of the
growth of the head size in fetuses increased more
intensively in pregnant fetuses in a state of
hypothyroidism. Analysis of the data shows that the
rate of increase in biparietal head diameteres in fetuses
of healthy pregnant women was 18.7%, frontal occipital
size - by 23.6%, head circumference - by 14.8%. In fetuses
of pregnant women in a state of hypothyroidism, these
indicators were 19.4%, 17.7%, 21.3%.
The smallest growth rate of fetometry indicators was
noted during the third screening examination. The
biparietal diameter in fetuses of healthy pregnant
women increased by 3.1%, the frontal occipital size - by
5.7%, and the head circumference - by 14.8%. In fetuses
of pregnant women in a state of hypothyroidism, these
indicators were 3.4%; 7% vs. 16%.
The growth rate of fetometry values in 12 to 35 weeks
in fetuses of healthy pregnant women increased
biparietal head diameter by 292.7%, frontal occipital
size by 297.8%, and head circumference by 313.7%.
In fetuses of pregnant women in a state of
hypothyroidism, during the studied period, the growth
rate of head parameters increased biparietal diameter
by 296%, frontal occipital size - by 295.6%, head
circumference - by 302.8%,
CONCLUSION
Thus, it can be concluded that in fetuses of pregnant
women in a state of hypothyroidism, the biparite and
frontal occipital head sizes are significantly smaller at
the stage of the second screening examination than in
fetuses of healthy pregnant women. The head
circumference of the fetuses of pregnant women in a
state of hypothyroidism at all stages is less than that of
the fetuses of healthy pregnant women.
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