Hyperthyroidism in pregnancy

Many women suffer from hyperthyroidism in pregnancy. It can be caused by high levels of a hormone called chorionic gonadotropin (the one detected by all pregnancy tests) that stimulates the thyroid gland to produce hormones. It may also have other causes, not related to pregnancy. Treatment of an overactive thyroid gland is necessary if thyroid hormone levels are very high.

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1. Pregnancy-induced hyperthyroidism

Mild hyperthyroidism in pregnancy may be related to the woman's physiological condition. The hormone produced by the placenta after implantation in the uterus, human chorionic gonadotropin (hCG), has a similar effect to TSH, especially at high concentrations. And TSH, or thyrotropin or thyroid stimulating hormone, is a hormone that stimulates the thyroid gland to produce thyroid hormones and increases its volume. In most cases, such an overactive thyroid gland during pregnancy causes pregnancy-like symptoms, and their severity is not too severe. It does not require treatment. If the hCG level is extremely high (e.g. in a multiple pregnancy), severe symptoms may develop, such as:

  • tachycardia,
  • hyperhidrosis,
  • stimulation,
  • systolic murmur over the heart,
  • breathlessness.

2. Other causes of hyperthyroidism

Whether or not a woman is pregnant, she may suffer from an overactive thyroid gland caused by other problems. These are:

  • Graves' disease,
  • nodular toxic goiter,
  • thyroiditis
  • thyroid adenoma,
  • unrestrained vomiting of pregnant women,
  • a bunny.

3. The effects of hyperthyroidism during pregnancy

The possible effects of uncontrolled hyperthyroidism during pregnancy (whatever its cause) are:

  • premature detachment of the placenta,
  • preeclampsia,
  • congestive heart failure,
  • premature birth,
  • miscarriage.

However, a child may develop complications such as:

  • an overactive thyroid gland
  • prematurity,
  • low birth weight,
  • hypotrophy.

4. Treatment of hyperthyroidism in pregnancy

Treatment varies depending on the cause of the onset of hyperthyroidism, as well as the point at which it appeared and was detected. The first test after suspicion of hyperthyroidism is the determination of the level of antibodies against the TSH receptor. You can also have an ultrasound of the thyroid gland to see if the thyroid gland is overactive.

Hyperthyroidism is usually treated with very low doses of antithyroid drugs. They are selected in such a way that they have the least possible impact on the child, both during pregnancy and during breastfeeding. These substances cross the placenta and can cause side effects in the fetus. However, the lack of treatment for hyperthyroidism may result in much more serious consequences. In the case of ineffectiveness of drugs, a surgical solution and thyroid gland surgery are sometimes chosen. Such an operation can be performed in the second trimester of pregnancy. Due to its toxicity, radioiodine is not used in the treatment of hyperthyroidism in pregnancy.

Hyperthyroidism should also be monitored after delivery. When it comes to childbirth, there are no special recommendations for it with proper thyroid function monitoring.

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