It’s not a secret that pregnancy is a serious test for the female body. During this period, all organ systems work more intensively than usual. This also applies to the work of the thyroid gland, which alone provides hormones to both the mother and the baby, until the fetus has its own endocrine system. Thyroxine and triiodothyronine are the hormones necessary for the mother and literally vital to the growing baby in the womb. That is why the state of thyroid hormone deficiency, called hypothyroidism, can make serious problems during pregnancy for the health of the child and the mother. So, what should a future mother know about hypothyroidism and pregnancy?
What Is Hypothyroidism?
Hypothyroidism is a syndrome caused by a persistent shortage of thyroid hormones. The occurrence of pathology among women bearing a child reaches 2%. Pregnancy while having hypothyroidism requires close medical observation because the absence of treatment in this condition is fraught with a negative effect on the fetus.
The thyroid gland is a part of the endocrine system. It has a direct or indirect effect on all body systems. For this reason it is important to know what hypothyroidism and pregnancy is fraught with. To understand the mechanism of development of thyroid hormone deficiency, one should consider its causes.
Hypothyroidism is a disease that is caused by a decreased function of the thyroid gland and, as a consequence, a decrease in thyroid hormone levels in the blood.
The disease occurs in 1.5-2% of pregnant women. The rarity is explained by the fact that with untreated hypothyroidism there is a big risk of developing infertility. Pathology cannot be detected for a long time, as it is characterized by gradual development and prolonged concealment of symptoms that can be confused with overwork, pregnancy or some diseases.
Causes of Hypothyroidism
Hypothyroidism and pregnancy – even according to doctors, are incompatible things. Still, even with such a diagnosis, a woman has the opportunity to bear and give birth to a healthy child. The most important thing is to pay attention to your condition, to control all changes in the body, and to detect the disease in time.
Clinically, the disease in pregnant women is no different from the course of the disease in all other people.
Hypothyroidism develops for a number of specific reasons:
- Surgical intervention, during which part or all of the thyroid gland was removed. The operations are performed in order to eliminate the tumor or other malignancies;
- Treatment of hyperthyroidism with the help of radioactive iodine;
- Ionizing irradiation;
- Genetic predisposition;
- Iodine deficiency in food and water;
- Failure of the pituitary gland;
- Hereditary factor (the development of the disease is provoked by genetic mutations);
- The disturbance of the formation of hormones;
- The damage of the hypothalamus which leads to serious disruptions in the endocrine system;
- Reduced sensitivity to thyroid hormones (the problem appears in connection with the use of certain medications).
Hypothyroidism is a fairly common pathology and occurs in 19 out of 1,000 women. Despite this prevalence, hypothyroidism is often not seen for a long time. This is partly due to the fact that the disease has a gradual onset and erased, nonspecific symptoms. Prevalence of hypothyroidism among pregnant women is 2%. Hypothyroidism in pregnancy is relatively rare, partially because with obvious untreated hypothyroidism infertility often develops in women.
Symptomatology of the Disease
Hypothyroidism during pregnancy is characterized by a number of symptoms:
- a woman starts to notice that she gets tired very quickly, working capacity decreases, drowsiness often occurs;
- the ability to concentrate is reduced, absentmindedness appears;
- memory deteriorates;
- the body temperature decreases regularly, the woman feels chill;
- skin becomes dry, some yellowing is observed;
- periodically there are problems with digestion, constipation, diarrhea, heartburn;
- there can be a gradual weight gain;
- there is swelling of the extremities;
- violation of the menstrual cycle;
- enlargement of the liver;
- brittle nails;
- hair loss;
- if the thyroid gland is enlarged, painful sensations appear in the throat during swallowing, breathing becomes difficult, voice can change; there are problems in the work of the heart and blood vessels.
Many women associate hypothyroidism and its symptoms during pregnancy with a number of other diseases. Still, such a symptomatology should cause a visit to a specialist and a comprehensive examination. Ignoring the problem can lead to complications. It will be hard to treat it and the treatment will take much longer.
Consequences for the Mother and the Baby
Deficiency of thyroid hormones can have a negative effect on both the future mother and the fetus. Pathology presents a particular danger in the first trimester, when the embryo’s organs and systems are being laid.
Uncompensated hypothyroidism during pregnancy can cause serious consequences for the child:
- Low birth weight.
- Physical and mental development delay.
- Anomalies of the structure.
- Congenital hypothyroidism.
- Severe hypothyroidism has a negative effect on pregnancy and can be dangerous for a woman. The aggravation of the pathology is explained by the use of maternal thyroid hormones in the first half of pregnancy.
- Spontaneous termination of pregnancy.
- Premature detachment of the placenta with heavy bleeding.
- Weak labor activity.
- Iron-deficiency anemia.
Complications can be a result of inadequate treatment of a future mother. Among the main consequences are:
- spontaneous miscarriage,
- early toxicosis,
- pregnancy can be interrupted at different terms of gestation,
- gestosis, placental abruption,
- death of the fetus inside the womb,
- bleeding after childbirth.
Congenital disease is dangerous for the fetus, since it affects the development of the central nervous system. It negatively affects the formation of the brain. A child can be born with a small weight, can have a congenital mental or neurological disorder.
The fetus in a woman with hypothyroidism is more likely to experience oxygen starvation during childbirth, and the mother is experiencing poor uterine contraction strength. Therefore, complications in childbirth are likely to occur. Children are very vulnerable to infectious diseases. In addition, all of them themselves are at risk for hypothyroidism.
It is known that until the sixteenth week of pregnancy the endocrine system has not yet fully formed in the fetus. In this regard, it develops under the influence of maternal hormones. Therefore, if the future mother has problems with the thyroid gland, hormones are not fully replenished. As a result, the child may suffer. The baby can begin irreversible changes associated with a decrease in intelligence. Such problems are possible only if the future mother does not take the necessary amount of drugs.
Hypothyroidism and Pregnancy: Diagnostics
Obstetricians-gynecologists and therapists who are conducting an examination of pregnant women should always be cautious about hypothyroidism and pregnancy. If a disease is suspected, a hormonal test is performed in which T4 (a thyroid hormone) and TSH (a pituitary hormone controlling the production of T4) are determined. If the T4 level is decreased, and the TSH is elevated, the diagnosis of primary hypothyroidism is obvious. This means that the condition is provoked by the disease of the thyroid gland. If TSH level is normal or below the norm, and T4 is also decreased, there is a hypothyroidism of the central genesis, in which the work of the pituitary or hypothalamus is disrupted.
In case if the screening revealed changes characteristic of primary hypothyroidism, an additional blood test for antibodies to the thyroid gland will be required. If it is positive, the problem lies in the damage of the gland cells with its own antibodies.
Hypothyroidism and Pregnancy: Treatment
Treatment of hypothyroidism during pregnancy is handled by an endocrinologist together with an obstetrician.
Pregnancy with hypothyroidism requires constant monitoring of the doctor and the application of treatment.
First, it is necessary to establish what caused the condition: lack of iodine or damage to the glands of internal secretion. In any case, potassium iodide is usually prescribed for treatment. If the cause of hypothyroidism lies in the pathology of the thyroid gland or pituitary gland, replacement therapy with thyroid medications is required. The most commonly prescribed drug is levothyroxine sodium.
Hypothyroidism and pregnancy are incompatible things. Hypothyroidism brings undeniable harm to the fetus. This is proven by many specialists, so the necessary treatment for a future mother should be done at the stage of pregnancy planning. Constant monitoring of the level of hormones during pregnancy will neutralize the negative consequences of the disease for the baby and the mother.