Thyroid disease in pregnancy

Facts about hypothyroidism and pregnancy

Thyroid disease is the second most common endocrine disorder that affect women of reproductive age. If left untreated during pregnancy, it is associated with growth restriction, hypertensive disorders, placental abruption, and miscarriage. Hypothyroidism is marked by an underactive thyroid gland and has symptoms similar to pregnancy, such as, abdominal menstruation, weight gain and fatigue are common symptoms in both. The low thyroid levels also interfere with getting pregnant and may cause a miscarriage. The symptoms of hypothyroidism may resemble other conditions. Talk to a Gynaecologist in North Nazimabad Karachi for a diagnosis.

Symptoms of hypothyroidism in pregnancy

Hypothyroidism is a common condition that often goes unnoticed if the symptoms are mild. In this condition the thyroid is making insufficient amounts of hormones. Initially the symptoms may start slowly and be mild. The most common symptoms of hypothyroidism are:

• Lethargy
• Intolerance to cold temperatures
• Hoarse voice
• Swelling of the face
• Weight gain
• Constipation
• Dry skin and loss of eyebrows
• Carpal tunnel syndrome
• Bradycardia (slow heart rate)
• Muscle cramps
• Difficulty concentrating
• Irregular menstrual periods

How does hypothyroidism affect the fetus?

            The fetus relies on the mother for thyroid hormone during the first few months of pregnancy. The hormone is important for the normal development of the brain and fetal growth. Hypothyroidism in the mother has long-lasting effects on the fetus.

Testing for hypothyroidism

To check for hypothyroidism, you will have a blood test that measures thyroid hormone (thyroxine or T4) and serum TSH (thyroid-stimulating hormone). Hypothyroidism is often suspected when levels of TSH are above normal, whereas T4 levels are below normal. Although routine screening for hypothyroidism is not recommended, a pregnant woman with a history of hypothyroidism and symptoms of hypothyroidism or with any other endocrine conditions should undergo screening.

Treatment for hypothyroidism during pregnancy

            Thyroid hormone replacement therapy is used for treating the mother. Dosage of the replacement therapy is based on the levels of thyroid hormone of the individual. Thyroid hormones tend to change during pregnancy; therefore, the dosage of thyroid replacement may also change. During the first half of the pregnancy, the levels of the hormone need to be checked every 4 weeks. The treatment is safe for both the mother and fetus. In addition, routine screening of thyroid includes a test for thyroid hormone levels.

            The preferred treatment for hypothyroidism includes antithyroid medications with the goal of maintaining the serum thyroxine levels within the upper one-third of the normal range. Postpartum thyroiditis is also a common form of postpartum thyroid dysfunction and presents as either hyper- or hypothyroidism. Symptomatic treatment is recommended for hyperthyroidism, whereas levothyroxine in women who are symptomatic, breastfeeding and wish to become pregnant. You can visit a Gynecologist in DHA Lahore to discuss available treatment options.

Thyroid disease is the second most common disease that affects women at a reproductive age, therefore, the current guidelines recommend that women at a high risk of hypothyroidism and with a history of autoimmune disease, type 1 diabetes mellitus and thyroid disease should be screened. Proper diagnosis and treatment help with appropriate management and improved outcomes.