Wednesday, July 2, 2014

Effect of Thyroid Dysfunction on Pregnancy



Pregnancy is a time when the woman needs to maintain perfect health condition, as staying disease free will help in the proper foetal growth and development. 

Hence, the need to screen for various diseases so that we can manage the health issues timely before any complications arise because of them. 

One of such problems is thyroid dysfunction during pregnancy. 

Dealing with thyroid dysfunction timely and adequately will prevent premature labour and lead to better neurological development of a foetus leading to healthy and intelligent babies.


What is thyroid hormone?

Thyroid hormone is secreted by a gland located in center of neck just below your Adam’s apple. This hormone is required for optimum functioning of all body parts including your muscles, stomach, bone, heart and brain.


What are common thyroid diseases and what are the common symptoms for same?


When thyroid gland produces less than desired levels of thyroid hormones, it is considered to be underactive or “hypothyroidism” and when it is over-producing then we call it “Hyperthyroidism”. Both of these states are harmful for baby as well as mother. Both of these states have distinct symptoms:



Hypothyroidism
                         Hyperthyroidism
  • Tiredness
  •  Depression
  •  Weight gain
  •  Feeling cold
  •  Dry skin and hair

  • Feeling too hot when others are comfortable
  • Rapid heartbeat
  • Trembling hands
  • Weight loss even though you eat enough
  • Tiredness and/or trouble sleeping
  •  Feeling irritable and anxious 





What are the risk factors for developing thyroid disease?

In large number of patients, there is no identifiable risk factor for thyroid disease. But certain risk factors do predispose for development of thyroid disease, especially for hypothyroidism.


1.     A family history of thyroid or autoimmune disease
2.     Type 1 diabetes or other autoimmune disease
3.     Prior radiation treatment of the head or neck
4.     Past thyroid surgery
5.     Thyroid antibodies, mainly thyroid peroxidase (TPO) antibodies, which are often present in Hashimoto’s disease
6.     Past infertility or preterm delivery
7.     A goiter (swelling of the thyroid gland)



When should I get myself tested for thyroid disease?

Every woman who is planning pregnancy should get herself tested for thyroid disease beforehand and in case of unplanned pregnancy, thyroid testing should be recommended at first visit to gynecologist.
The reason for such liberal recommendation is two- fold. Firstly, it is an easily treatable disease and secondly, treatment is cheap and generally has no associated side-effects.



How are thyroid disorders detected?

To detect thyroid disorders, your doctor does a physical exam and orders blood tests to 
measure your thyroid hormone levels.
In the blood tests, main conclusion is drawn from a test called serum TSH. Interpretation of TSH values requires understanding of normal physiology of thyroid gland.


























How do I treat my thyroid problems in pregnancy?

In pregnancy, you need to start some medications for both types of thyroid diseases, in consultation with your endocrinologist.
Treatment of hypothyroidism involves replacement with tyroid hormone i.e. T4. This hormone has been prepared with recombinant technology and is exactly same as is being produced inside your own thyroid gland.
For hyperthyroidism, drugs are given to suppress your thyroid gland from producing more thyroid hormone.



Why is it so necessary to take treatment for thyroid problems in pregnancy?


Maternal hypothyroidism poses a risk for both mother and baby, if left untreated. A pregnant woman’s thyroid hormones are vital not only for her but also for the development of her baby. Pregnant women with uncontrolled hypothyroidism can get high blood pressure, anemia (low red blood cell count), and muscle pain and weakness. There is also an increased risk of miscarriage, premature birth (before 37 weeks of pregnancy), or even stillbirth.
Pregnant women with uncontrolled hyperthyroidism may develop high blood pressure. 

There is also an increased risk of miscarriage, premature birth, and having a baby with a low birth weight.



Is there anything to worry?

No, there is nothing to worry. If treated well, thyroid diseases pose no risk to mother or child. So, importance of screening for thyroid disease in pregnancy cannot be over-emphasized.
 




Contributed By:
Dr Rajiv Singla
Consultant Endocrinology
MD, DM - Endocrinology & Metabolism.
At KVSC, we believe in providing you updated, ethical and evidence based care to you. We invite your valued feedback   

No comments:

Post a Comment