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Thyroid During Pregnancy!

Dr. Garima Kaur 93% (288 ratings)
MICOG, MS, MBBS
Gynaecologist, Pitampura  •  13 years experience
Thyroid During Pregnancy!

Nothing can be more gratifying than welcoming your bundle of joy into this world. Care needs to be taken during pregnancy to ensure that the developing foetus is healthy. Many pregnant women suffer from Thyroid problems. Thyroid Stimulating Hormone (TSH) is an important hormone produced by the Pituitary gland. TSH regulates the production and action of the Thyroid Hormones (T3 and T4). Estrogen and Human Chorionic Gonadotropin also affects the production of the thyroid hormones. Abnormal level of thyroid hormones in the body can result in Hyperthyroidism (increased production of thyroid hormones) or Hypothyroidism (decreased production of thyroid hormones by the thyroid gland). These conditions, if left untreated, can prove to be fatal for the mother and the baby.

Hyperthyroidism is greatly affected by an autoimmune disease, the Graves disease. The Thyroid Stimulating Immunoglobulin (TSI), produced during Graves disease, interferes with the production of the thyroid hormones. The TSI mimics the TSH to a great extent. This triggers the thyroid gland to produce the thyroid hormones in excess. A woman with hyperthyroidism may complain of increased heart rate, fatigue and increased blood pressure. There may be heat intolerance, tremor, sudden weight loss and Hyperemesis Gravidarum.

Untreated Hyperthyroidism can result in heart ailments, premature child birth, foetal Tachycardia, Preeclampsia (a pregnancy complication characterised by an abnormal rise in blood pressure) and miscarriage. In case of foetal and neonatal Hyperthyroidism, there is low birth weight, heart ailments, irritability and poor brain development.

Blood tests, whereby the levels of T3, T4, TSH and TSI are examined, can help in the diagnosis of Hyperthyroidism. Women with Graves disease should be extra careful. Antithyroid drugs can provide great relief. Most antithyroid drugs successfully cross the placenta and effectively regulate the production of the foetal thyroid hormone. Propylthiouracil (PTU) and Methimazole are effective anti-thyroid drugs.
Most doctors recommend Methimazole during the first trimester and PTU during the last two trimesters.

In case of Hypothyroidism, Hashimoto disease is the main wrecker in chief. This autoimmune disease results in considerable decrease in the production of thyroid hormones. Hypothyroidism can also be aggravated by Thyroidectomy (surgical removal of thyroid gland). Like hyperthyroidism, hypothyroidism during pregnancy can result in serious health complications. There may be stillbirths, congestive heart failure, miscarriage, anaemia, poor brain development of the newborn and Preeclampsia. Symptoms like cold intolerance, muscle cramps, concentration problems, fatigue or constipation should not be taken lightly.

Blood tests (T4 and TSH) go a long way to detect Hypothyroidism. A synthetic Thyroid hormone, Thyroxine, is effectively used to treat hypothyroidism. Including iodine supplements in your diet prove to be helpful in hyperthyroidism treatment.

Thyroid problems, though serious, can be successfully treated. A little alertness during pregnancy can shield both the mother and the newborn from the harmful consequences. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

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