Up to 5% of pregnancies are affected by thyroid problems. thyroid size and thyroid hormone production increase throughout pregnancy, thyroid binding globulin concentrations rise up to mid-pregnancy due to high estrogen levels, serum thyrotropin (TSH) levels fall early due to direct thyroidal stimulation by human chorionic gonadotropin, and iodine requirements rise due to increased renal clearance and losses to the feto-placental unit. During pregnancy, there are primarily two types of thyroid disorders:
Pregnancy-related hypothyroidism: 2 to 3 pregnancies out of 100 have this condition, which is typically brought on by Hashimoto's illness.
Graves' illness is typically the cause of hyperthyroidism in pregnancy, which affects one to four pregnancies out of every 1,000.
When a woman has a limited thyroid reserve during pregnancy, she may develop hypothyroidism. Pregnancy can be thought of as a stress test for the mother's thyroid function.
Weight gain, intense weariness, difficulty coping with the cold, muscle cramps, severe constipation, and memory or concentration issues are all signs of hypothyroidism.
Nausea, an increased hunger, a fast and erratic heartbeat, trembling hands, and unexplained weight loss or failure to gain weight during pregnancy are all symptoms of hyperthyroidism.
Book an appointment with your gynaecologist right away if you experience any of these symptoms
Hypothyroidism
The thyroid is attacked by antibodies produced by the immune system, which results in inflammation.
Hyperthyroidism
Antibodies produced by the immune system lead to an overproduction of thyroid hormone by the thyroid. termed thyroid stimulating immunoglobulin this antibody (TSI).
It may be difficult to diagnose thyroid illnesses during pregnancy since some clinical symptoms of thyroid disorders resemble those of pregnancy
Laboratory tests
Prior to or during the first trimester, targeted TSH monitoring for women at high risk for thyroid illness is strongly advised.
Equilibrium dialysis combined with mass spectrometry is the gold standard for measuring free T4 concentrations during pregnancy.
Thyroid hormone levels should also be checked, as should your blood for specific antibodies.
Additional thyroid function tests should be performed to confirm the diagnosis and the severity of the disease.
If you have borderline values, your gynaecologist may need to repeat laboratory sampling within a week to confirm diagnoses.
The majority of clinical decisions about the treatment of hypothyroidism or hyperthyroidism are based on the blood TSH levels, general clinical picture, and symptoms.
Hypothyroidism management
Using the reference intervals particular to pregnancy, levothyroxine is the preferred medication for treating hypothyroidism with the intention of restoring normal serum TSH values. It is secure for your infant and crucial until he or she is able to produce thyroid hormone on their own.
Hyperthyroidism management
Before and during pregnancy, hyperthyroidism should be properly managed.
Pregnancy-related mild hyperthyroidism won't require medication.
If hyperthyroidism and hyperemesis gravidarum are related, all you'll need is dehydration and vomiting medication.
Antithyroid medications, which induce your thyroid to produce less thyroid hormone, are the way to go if hyperthyroidism is more severe. It is strongly encouraged to speak with a specialist who can closely monitor your child to ensure you're getting the proper dosage, such as an endocrinologist or an authority in maternal-fetal medicine.
The aim of treatment for both hypothyroidism and hyperthyroidism is to swiftly reach and maintain euthyroidism throughout pregnancy.
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