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Thyroid In Pregnancy
Caring for You, Always
The thyroid function plays an important role in reproductive health of the women. Thyroid disorders are an important cause of infertility, and miscarriage and bad obstetric outcome. Thyroid hormone plays an important role in the development of the foetal brain. An adequate amount of Iodine is required to make thyroid hormone and therefore iodine supplementation in the form of fortified foods (salt) is essential.
All women who are planning a pregnancy and those who are already pregnant should do a thyroid check as it is important to identify and treat even before one conceives. Thyroid problems can easily be tested and treated.
During pregnancy the requirement for thyroid hormone increases. Women with mild deficiency may therefore have mild disease and may have mild or no symptoms. The symptoms are so common that they may be considered as normal features of pregnancy (eg. Constipation and lethargy) and therefore diagnosis can be missed.
Mild hypothyroidism can also lead to miscarriage, preterm labour, increased blood pressure and associated problems in pregnancy.
It is easy to treat hypothyroidism. Levothyroxine sodium pills are completely safe for use during pregnancy. The tablet should be taken about half an hour before eating in the morning. Dose is adjusted so that the S TSH level is within the acceptable range for pregnancy (slightly lower than the normal value for the non-pregnant state.) Those women who are already taking treatment before conceiving need to re-adjust the dose once pregnancy is diagnosed. It is important that one should not stop the thyroid medicine as soon as the TSH level is normal (this is common mistake done by many).
Hyperthyroidism can occur in pregnancy though it is not as common as hypothyroidism. It is also difficult to diagnose as the symptoms are very common features of pregnancy eg. Shortness of breath and being aware of one’s heartbeat. If uncontrolled and untreated then it can lead to miscarriage preterm labour, intrauterine growth restriction and intrauterine foetal death.
Very mild hyperthyroidism usually does not require treatment, only routine monitoring with blood tests to make sure the disease does not progress. Treatment choices are limited in pregnancy as the drugs too can have adverse effects on the foetus.
Therefore, in pregnancy if there is any thyroid disorder, It is imperative to be under the supervision of a thyroid specialist for effective management and control.