Just like high thyroid hormone levels in the mother, low thyroid hormones levels—or hypothyroidism have a lot of effect on the developing baby. However, it can go undetected as the symptoms of pregnancy overlap with those of hypothyroidism. Women already diagnosed with hypothyroidism should disclose their history to the Gynecologist in Islamabad so they can be monitored throughout the pregnancy.
Read on to know what the impact of hypothyroidism is on pregnancy and how to deal with it:
What are the causes of maternal hypothyroidism?
Hashimoto’s thyroiditis-induced hypothyroidism is responsible for 2 to 3 out of every 100 pregnancies. This autoimmune disorder is characterized by antibodies that attack the thyroid, causing its inflammation and eventually damage. The thyroid is consequent unable to maintain the serum thyroid levels in the body.
Who is at risk of hypothyroidism?
Women who are over the age of 30 years are at risk of hypothyroidism, along with the following:
- women with a history of preterm labor
- women with a history of thyroid surgery
- women with type I diabetes or any other autoimmune disease
- women with a family history of thyroid disorders
- women with prior history of radiation therapy of the head and neck
- women with positive serum thyroid antibodies—like thyroid peroxidase (TPO).
Routine testing of hypothyroidism is not recommended in pregnant women. However, women with a history of the aforementioned factors should be screened.
What are the symptoms of hypothyroidism?
In pregnant women, hypothyroidism presents with: extreme tiredness and fatigue. The symptoms of hypothyroidism mimics those of pregnancy, which is why it is often overlooked. Other symptoms include: severe constipation, feeling extreme cold even when others are not and muscle cramps. Additionally, the patient may have trouble concentrating and remembering things. Such patients also have dry skin, hair changes, swelling of the face, hoarse voice and a slow heart rate. In subclinical hypothyroidism, there are often no symptoms and the diagnosis is accidental.
During the first few months of pregnancy, until the thyroid gland of the baby develops, the fetus is dependent on the mother for thyroid hormones. They are needed for the normal brain development and growth. Without these hormones, there can be severe effects in the baby.
Effect of hypothyroidism
Hypothyroidism negatively impacts the baby and can be dangerous for the mother as well. There can be preeclampsia in the late pregnancy, which is characterized by very high rise in blood pressure and urinary protein loss. Hypothyroidism mothers are often anemic, and have high risk of miscarriage and stillbirth. The babies have low IQ, low-birth weight and neural deficit.
How is hypothyroidism treated?
The mainstay of treatment for hypothyroidism is hormone replacement.
Before pregnancy patients of hypothyroidism are encouraged to maintain a euthyroid state. For women already taking exogenous T4, thyroid hormone levels should be checked before conception and during pregnancy. In case of high TSH levels despite medication, the dosage needs increasing. It is recommended to delay getting pregnant until the disease is controlled.
During pregnancy the dose of exogenous T4 often needs to be increased. During the first trimester, this increase is 30 percent or more of the regimen the mother is already taking. Soon after pregnancy is confirmed, the basal levels of serum TSH and free thyroid hormones should be checked to design the treatment regimen.
For newly diagnosed cases of hypothyroidism during pregnancy, T4 is given until normal serum levels are reached. The hormone levels are retested every 30 to 40 days. Exogenous T4 is also recommended for women who have subclinical levels of thyroid hormones.
After pregnancy the dose of exogenous T4 needs to be tapered, as seen fit by the specialist endocrinologist available for booking at oladoc.com.