Thyroid disorders that are possible during pregnancy

Most often, the thyroid gland during pregnancy increases in size, due to an increase in the functional load on it to produce hormones to meet the needs of the mother and baby. If there are no health problems, the course of pregnancy is quite normal, the baby develops in time – this is attributed to physiological changes. However, one should not forget that the change in the size of the thyroid gland, especially, very pronounced, visible to the naked eye and asymmetric, can indicate a number of serious pathologies. This is especially true for those women who, even before pregnancy, had some problems with the work of this endocrine organ. Let’s find out how various pathologies affect the bearing of the fetus and pregnancy outcomes.

Deviations from the norm: hypothyroidism, thyrotoxicosis, hormone imbalance

In relation to the thyroid gland, two types of deviations in the work and production of hormones can be distinguished in principle. This is hypothyroidism, a decrease in organ function, when hormones are produced in very small quantities, and the opposite is the state of hyperthyroidism (thyrotoxicosis), excessive production of hormones. Both of these conditions are extremely undesirable during pregnancy, because they significantly affect the course of pregnancy and the development of the baby.

Hypothyroidism can occur due to various reasons leading to suppression of hormone synthesis, which disrupts the metabolic processes of the female body. Often it has an autoimmune nature, proceeding as a chronic pathology, or deficient if the woman’s diet has very little iodine and there is simply not enough building material from which hormones are synthesized. Timely determination of this condition in pregnant women is difficult, since many clinical manifestations of hypothyroidism are largely similar to the first signs of pregnancy. Therefore, if hypothyroidism is suspected, the first thing to do is to take a blood test and determine the level of thyroid hormones and pituitary hormones (TSH) in it, this will give a clear picture of the gland malfunction.  

The opposite state, hyperthyroidism, is an increase in the activity of the thyroid gland, often accompanied by an increase in its size or the formation of nodes that produce hormones. During pregnancy, this condition rarely occurs, and its main manifestations will be attacks of severe vomiting and bulging eyes (bulging eyeballs from orbits). If pregnancy has occurred against the background of hyperthyroidism, this can become a provocation of a thyrotoxic crisis, which threatens with its interruption and loss of the baby.

Therefore, if there are problems in the thyroid gland, before planning pregnancy, it is necessary to undergo a comprehensive examination and normalize the work of the gland in the production of hormones. 

Pregnancy with thyroid adenoma

The thyroid gland is a special organ consisting of glandular tissue, and in it the formation of benign processes – adenomas. The presence of adenoma is not a contraindication for pregnancy and childbirth. However, it is worth remembering that often an adenoma can be hormonally active, and produces an excessive amount of hormones, which leads to changes in the gland and metabolic disorders in the body. The main manifestations can be increased fatigue, increased sweating, nausea and sudden changes in mood. Similar symptoms are typical for the early weeks of pregnancy, so it is difficult at times to make the right diagnosis right away. 

Often a small adenoma does not affect pregnancy in any way, without complicating it, it is extremely rare for it to go into a malignant neoplasm, with metastasis in the body. If an adenoma is detected during pregnancy, it is important that the endocrinologist constantly monitors the entire period of gestation.

Hyperplasia of the gland: effect on the baby

The thyroid gland can be prone to hyperplasia, this is an overgrowth of organ tissue due to exposure to irritating factors. Often, this condition is provoked by hormonal dysfunctions, especially typical for the period of gestation. Hyperplasia per se is not dangerous, the baby develops quite normally with this standing, but an enlarged organ in size can interfere with the pregnant woman’s normal breathing, squeezing the trachea and larynx, causing the appearance of a net of blood vessels in the neck, and disrupting normal swallowing of food.

Hyperplasia is usually detected by ultrasound of the thyroid gland, which immediately clarifies the situation. Often, treatment with drugs with an increased amount of iodine helps, which is extremely useful for the baby to grow and develop normally, especially in the later stages, when its gland itself synthesizes hormones. To prevent this condition, it is useful to eat iodized foods.

Gland hypoplasia: effects on pregnancy

Organ hypoplasia is its intrauterine underdevelopment, this condition is rare during pregnancy, not more than 1% of expectant mothers due to the fact that it is usually combined with a pronounced hormone deficiency and infertility. Acute hormone deficiency leads to impaired physical development and brain activity, disrupts the nervous system. Often this condition is accompanied by severe hypothyroidism. If such a pathology was detected in early childhood and the girl was prescribed adequate hormone replacement therapy, then she should not have problems with bearing a baby. Against the background of pregnancy, she simply carries out correction of doses of hormones. If the condition is subclinical, the degree of hypoplasia is not very pronounced, then during pregnancy, when the load increases sharply on the gland, hypothyroidism with hormone deficiency can manifest itself, this will lead to miscarriages, miscarriage of pregnancy or a constant threat of premature birth. Without adequate correction, this condition threatens congenital hypothyroidism to the fetus, as well as the formation of severe malformations of the brain or internal organs.

The diagnosis is made on the basis of data from an ultrasound examination of the thyroid gland and a sharp decrease in its size and volume. A blood test for the level of thyroid hormones also confirms the diagnosis.

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