Content:

• Thyroid function during pregnancy
• Hyperthyroidism in Pregnancy
• Hypothyroidism in Pregnancy

Hyperplasia of the thyroid gland, that is, its enlargement, is always a sign of the dysfunction of this organ and indicates the presence of a disease. In many cases, thyroid hyperplasia does not become an obstacle to pregnancy. However, this condition requires constant monitoring, correction in order to minimize harm to the unborn child. 

Thyroid function during pregnancy

Until the 14-16th week of the fetus, its thyroid gland is not yet developed and does not function. For this reason, to ensure the normal development of the nervous system, brain and the general formation of a healthy child, Mom’s thyroid gland begins to work in an enhanced mode.

Thus, pregnancy significantly increases the load on the thyroid gland, which can lead to its hyperplasia. It can be of a compensatory nature, that is, due to an increase in the size of the gland, the production of hormones necessary for a given period of time is enhanced. However, hyperplasia can also be caused by a pathological condition when the thyroid gland does not cope with the increased needs of the body or continues to produce too many hormones when this is no longer necessary. In these cases, an enlargement of the thyroid gland is accompanied by hypothyroidism or hyperthyroidism.

Hyperthyroidism in Pregnancy

Most often during pregnancy, diffuse toxic goiter occurs. Increased thyroid function and its hyperplasia always accompany this disease.

Symptoms

• Heartbeats
• Fatigue,
• Sleep disturbance,
• Nervousness,
• Increased sweating and sensation of heat,
• Tremor of the hands.

Since hyperthyroidism is characteristic of the onset of pregnancy, the symptoms of diffuse toxic goiter exacerbate during this period. In the second half, improvement may occur, since there is a blockage of excess hormones. However, with a disease that has formed before pregnancy, such an improvement does not always happen.

Complications of diffuse toxic goiter in pregnant women:

• Threatened abortion,
• Severe form of early toxicosis,
• Decompensation of the cardiovascular system,
• The threat of bleeding.

With diffuse toxic goiter, complications are the most dangerous. So, in 50% of cases, an excess of thyroid hormones disrupts the implantation of the fetal egg and negatively affects its development. This leads to the threat of abortion.

Pregnant early toxicosis is not uncommon, but its combination with hyperthyroidism means a very severe course. Such toxicosis is difficult to treat and may necessitate termination of pregnancy. Late toxicosis in women with hyperplasia and pathological hyperfunction of the thyroid gland is less common, but it is also difficult. In this case, the greatest threat is an increase in blood pressure.

At about week 28, against the background of diffuse toxic goiter, cardiovascular decompensation may develop, accompanied by tachycardia, arrhythmia. The development of bleeding can be triggered by this disease in the early postpartum period.

Treatment of diffuse toxic goiter during pregnancy is a serious problem, since the effect of iodine preparations is small, and it is impossible to treat mercazolil because of the danger to the child. If necessary, surgical treatment is applied for up to 14 weeks. Symptomatic treatment with herbal remedies, diet is indicated.

The presence of an average and severe degree of diffuse toxic goiter in the expectant mother in most cases leads to pathologies in the development of the child, therefore, most often it is necessary to solve this issue by terminating the pregnancy. With a mild degree of the disease, the bearing of the fetus and the birth of a healthy baby are possible.

Hypothyroidism in Pregnancy

Pregnancy with thyroid hyperplasia due to reduced hormone production is relatively rare. Hypothyroidism significantly affects reproductive function, that is, often causes infertility.

Symptoms

• Chilliness
• Inhibition, drowsiness,
• Fast fatiguability,
• Cramps
• Dry skin.

Uncompensated hypothyroidism during pregnancy interferes with the normal formation of the fetus and may cause interruption. As a treatment, hormone replacement therapy with L-thyroxine is used. If such treatment was started before pregnancy, then a dose adjustment is necessary upward. In the second half of pregnancy, the dosage of the hormone can be reduced, but, as a rule, the drug is continued.

A favorable outcome is quite possible, but for this you need to control the condition and function of the thyroid gland.