September 3, 2022

Thyroid and Pregnancy

how does thyroid affect mother and baby




Understanding Hypothyroid in Pregnancy

Hypothyroidism is defined as Thyroid hormone deficiency with lowFT4 levels and elevated TSH levels.
The most common cause of hypothyroidism is iodine deficiency.
Symptoms of hypothyroidism :
The common symptoms include fatigue ,weight gain , decreased exercise capacity and constipation.
Other symptoms include hair loss , dry skin and bradycardia , which may be evident only in more symptomatic Persons.
Effects Of hypothyroidism on pregnancy:
  1. Mother: Anaemia , Gestational hypertension, Miscarriages, Pre eclampsia, Placental abruption, preterm birth
  2. Foetus: Foetal neuro cognitive deficits, Low-birth-weight,Increased perinatal morbidity and mortality
Children born to mothers who had poorly controlled hypothyroidism during pregnancy showed impairment of neuro psychological development indices and school learning abilities.
Levothyroxine is the mainstay of treatment for maternal hypothyroidism. The dose adjustment is based mainly on the TSH measurement. Serum TSH level should be measured every 4 to 6 weeks until 20 weeks Of gestation and Until the patient is on stable medication dose. Serum TSH should be measured again at 24 to 28 weeks and 32 to 34 weeks of gestation and the Levothyroxine dose to be adjusted.
Post-delivery, the TSH levels are checked six weeks after delivery and levothyroxine dosage adjusted accordingly.
Timely treatment reduces the incidence of miscarriages and Preterm birth and also improves fetal intellectual development.

Thyroid and Pregnancy

Understanding Hyperthyroid in Pregnancy

Incidence of hyperthyroidism is less common than hypothyroidism during pregnancy.
Hyperthyroidism is defined as elevated FT4 and low TSH levels.
Clinical symptoms of hyperthyroidism include :
tachycardia, nervousness, tremors, sweating, heat intolerance, proximal muscle weakness, frequent bowel movement, decreased exercise tolerance and hypertension.
The commonest cause of hyper thyroidism is Graves’ disease. Graves’ disease is an autoimmune disorder in which antibodies are formed against the TSH receptors .
Other causes of hyperthyroidism are
1.Gestational trophoblastic disease
2.Nodular goiter
3.Viral Tyroiditis
4.Tumours Off pituitary Gland or ovary.
Transient hypothyroidism may also be associated with hyperemesis gravidarum( excessive vomiting of pregnancy).
Effects of hyperthyroidism on pregnancy
1. Mother: Fatigue, horse voice, swelling of the face, weight gain, constipation, dry skin, loss of hair
2.Foetus: Growth restriction, hydrops, goiter, cardiac failure.
Women at high-risk, Women receiving antithyroid medication and those with poorly controlled hyperthyroidism , should undergo fetal sonography on a monthly basis after 20 weeks of gestation to detect any evidence of fetal thyroid dysfunction like growth restriction, hyrops, cardiac failure etc. These women should also undergo weekly testing starting from 32 weeks of gestation or even earlier in case of high-risk situations.

Thyroid and Pregnancy

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