Thyroid in pregnancy

12 Aug

Thyroid in pregnancy

The thyroid gland makes hormones necessary for the body to function, including hormones essential for a safe and healthy pregnancy. Abnormalities in the thyroid can lead to abnormalities in the pregnancies, ranging from birth before the due date to miscarriage in extreme cases. Thus, pregnant women must be aware of the risks associated with thyroid during pregnancy and take the necessary medications to ensure a healthy pregnancy.

What is Thyroid?

The thyroid gland is an integral part of the endocrine system in the body. By producing the thyroid hormones – Triiodothyronine and Thyroxine, the gland ensures the proper functioning of all organs, including during pregnancy. However, when the gland malfunctions and there is either an excess or deficiency of these hormones, thyroid disorders occur. These disorders can be due to pre-existing thyroid in pregnant women, although instances of such conditions occurring during and even after pregnancy are also common.

What are the risks associated with hyperthyroidism during pregnancy?

Hyperthyroidism occurs during pregnancy when there is excessive production of hormones from the thyroid. There are multiple risks and symptoms associated with hyperthyroidism during pregnancy:

Graves’ Disease: It is an autoimmune disease that causes hyperthyroidism during the pregnancy term. The presence of this disease during, or even before, pregnancy leads to a highly increased chance of the baby developing thyroid conditions after birth.
Preeclampsia: Preeclampsia is a condition of extremely high blood pressure generally occurring in the second trimester, often implying abnormal functions of the liver and kidneys. According to research, hyperthyroidism has been linked to an increased potential for preeclampsia in women, necessitating immediate medical attention.
Placental abruption: Hyperthyroidism has also been identified as a major risk factor for placental abruption, a condition where the placenta detaches from the uterus before the baby’s birth. This condition puts the health of the mother and baby at risk, requiring immediate medical supervision.

What are the risks associated with hypothyroidism during pregnancy?

Hypothyroidism during pregnancy occurs in the event of insufficient production of the thyroid hormones. Associated risks and symptoms for the mother and baby include:

Gestational Anemia: Hypothyroidism is a major risk factor for the development of gestational anemia. Regardless of whether it has been treated, it can cause issues in the latter half of the pregnancy.
Postpartum Hemorrhage: Untreated hypothyroidism can act as a catalyst for excessive postpartum haemorrhage, lasting from just one day upto 12 weeks after giving birth.
Myxedema: Myxedema is another life-threatening condition potentially caused by hypothyroidism. Deposit of sugar molecules associated with swelling refers to as Myxedema and occurs due to untreated hypothyroidism. In severe cases, it can lead to the mother going into a coma or even passing away in extreme cases.

How to treat thyroid during and after pregnancy?

While treating thyroid during pregnancy poses certain risks, such as threats to the baby and during breastfeeding, various medications and treatments for thyroid have been proven to be safe for babies. Regular tests of TSH levels and T4 levels can help monitor the increase or decrease in thyroid levels, allowing the physicians to prescribe medication accordingly. For treating hypothyroidism, Levothyroxine has been identified to be ne of the most commonly prescribed medications, which is also safe for pregnant women. For hyperthyroidism, propylthiouracil is an antithyroid medication most widely used.

How to deal with Postpartum Thyroiditis?

Postpartum Thyroiditis is a considerably rare condition where the thyroid gland swells up after the baby’s birth. It can be treated with medication, and the condition can persist in the first year after giving birth. Beta-blockers and prednisone are generally prescribed for an overactive thyroid, while hormone replacement is provided for an underactive thyroid.

Conclusion

The thyroid can lead to the emergence of many risks and complications during pregnancy, affecting the mother and baby equally. To minimize the risk, regular monitoring of hormone levels and medication prescribed by the physician must be regularly consumed. This can reduce the chances of any complications and reduce the possibility of the baby being born with thyroid as well.

References:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/postpartum-thyroiditis

https://academic.oup.com/jcem/article/101/12/5037/2765091

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174567/

https://www.marchofdimes.org/complications/thyroid-conditions-during-pregnancy.aspx

https://www.aafp.org/afp/2014/0215/p273.html

https://www.thyroid.org/thyroid-disease-pregnancy/

https://www.thyroid.org/hypothyroidism-in-pregnancy/

https://www.thyroid.org/hyperthyroidism-in-pregnancy/