Pregnancy is a special period in a woman's life. Significant changes are taking place in the body that affect the endocrine system, because hormones are directly involved in the conception and proper development of the fetus. It is necessary to control their level in the body of a pregnant woman, because even the slightest deviations from their norm can lead to serious consequences. One of the dangerous disorders in the endocrine system is considered to be hyperthyroidism during pregnancy. What is it and what does it threaten mother and fetus, we will consider in the article.
What is hyperthyroidism?
Hyperthyroidism is a condition characterized by increased production of thyroid hormones. With this diagnosis, the level of hormones T3 and T4 in the blood increases, as a result of which metabolic processes are accelerated. It happens that such a pathology occurs during pregnancy, which can cause serious violations in the development of the child, since excess hormones can come to him due to placental circulation. Due to the fact that hyperthyroidism during pregnancy can have a serious effect on the fetus, it is extremely necessary to control the hormonal background both during pregnancy planning and during the period of gestation.
Causes of pathology
The work of the thyroid gland affects the functioning of the whole organism as a whole. During childbearing due to global hormonal changes, the level of hormones produced by it also changes under the influence of some factors that can provoke hyperthyroidism during pregnancy. Consider the most common of them.
- First of all, the hCG hormone, which indicates the presence of pregnancy, affects the increased production of T3 and T4. It also has a stimulating effect on the tissue of the thyroid gland, due to which its functions are enhanced.
- It happens that hyperthyroidism during pregnancy occurs due to severe toxicosis, which is accompanied by indomitable vomiting. As a rule, in this case, the pathology disappears after a while.
Deviations from the norm of thyroid hormones also occur due to the following diseases:
- Bazedov’s disease. This pathological condition is responsible for the development of hyperthyroidism in most cases. It is an autoimmune disease in which the body produces certain antibodies that provoke increased production of thyroid hormones.
- Tumor formations of the pituitary gland.
- Toxic adenoma, in which there is an enhanced functioning of any particular area of the thyroid gland.
- Malignant formations of the ovaries or brain.
- Thyroiditis. It occurs due to inflammatory processes occurring in the thyroid gland. In most cases, the cause of this disease is viral infections.
- Taking certain medications, including hormones.
- Immune system disorders.
- Bubble skid. A rare pathology of the fetal egg, which occurs due to insufficient stimulation of the thyroid gland with the hormone hCG.
- Improper nutrition.
Classification
Some experts distinguish the following types of pathology:
- Transient hyperthyroidism during pregnancy. This is a physiological condition that occurs in the first weeks of bearing a baby. This condition is characterized by the fact that in the first half of pregnancy the fetal thyroid gland does not yet function, therefore, the maternal gland takes on its role. In this case, T3 and T4 can grow 2 times. This is a normal condition that does not require treatment. As a rule, after a certain time, the level of hormones comes back to normal. It happens that in some women the concentration of thyroid hormones exceeds the norm that is acceptable during pregnancy, while TSH decreases. Transient gestational hyperthyroidism develops during pregnancy, which is accompanied by all the unpleasant symptoms.
- Acquired hyperthyroidism, the causes of which are thyroid gland pathologies. This type of pathology is diffuse goiter.
- Acquired hyperthyroidism, which occurs with improper hormone therapy.
The modern classification distinguishes three types of this pathology:
- Primary hyperthyroidism, the main cause of which is malfunctioning of the thyroid gland.
- Secondary is caused by a malfunction of the pituitary gland.
- Tertiary, in which pathological processes occur in the hypothalamus.
Primary hyperthyroidism, in turn, is divided into the following types:
- Subclinical when thyroid-stimulating hormones are normal and TSH is low. In this case, the course of the pathology will be asymptomatic.
- Manifest. Thyroid hormones are elevated, and TSH is lowered. Symptoms are characteristic.
- Complicated. It manifests itself as psychosis, weight loss, heart or adrenal insufficiency.
Symptoms
Signs of hyperthyroidism during pregnancy occur gradually, and pathology can occur not only during the period of gestation, but also before pregnancy.
The most common symptoms of an increase in thyroid hormones include:
- Unreasonable increase in body weight or low weight gain.
- Psychological disorders - depression, nervousness, anxiety.
- Jumps in blood pressure.
- Fever.
- Heart rhythm disturbances.
- Increased heart rate.
- Drowsiness.
- Excessive sweating.
- Heat intolerance.
- Doubling of objects.
- Dyspnea.
- Light tremor.
- Upset stool.
- Enlargement of the thyroid gland.
- Eyebrows.
- Weakness.
- Great thirst.
- Muscle fatigue.
- Frequent urination.
- Nausea and vomiting.
- Hair loss.
In the more advanced stages of the disease, conditions such as:
- Dry skin.
- Swelling of the eyelids.
- Pain in the eyes.
- Violations of the stool.
- Pain in the navel.
- Lesions of the liver.
- The most dangerous condition is a thyrotoxic crisis, which can threaten not only the health, but also the life of a woman and a child.
Since the signs of hyperthyroidism during pregnancy can easily be confused with typical manifestations that occur during gestation, the diagnosis of pathology often occurs quite late. Therefore, do not neglect the appointments of the attending physician and timely pass all the necessary tests.
Diagnostics
Since hyperthyroidism during pregnancy, the effect on the fetus is very serious, timely diagnosis of pathology is very important. This is especially important for those women who, prior to conception, had problems with the thyroid gland or if any of the above symptoms were detected.
Let us consider in more detail the possible diagnostic measures.
- First of all, it is necessary to visit an endocrinologist who will conduct an examination and collect a medical history, where he will clarify the presence of a hereditary factor, early cases of hormonal background failures, nutritional features, and more.
- Next, a venous blood test for thyroid hormones is prescribed.
- A general analysis of urine and blood, which can indicate the presence of an inflammatory process in the body.
- Blood coagulation test.
- Ophthalmological studies.
- ECG.
- Ultrasound examination of the thyroid gland.
- Sometimes you may need an MRI or CT scan.
- Thyroid biopsy.
- The condition of the child is assessed by ultrasound with dopplerometry.
Treatment
The treatment of hyperthyroidism during pregnancy is carried out by an endocrinologist-gynecologist. It is very important at the same time to choose a competent specialist who will choose the right drugs, because many of them can bring significant harm to the fetus.
Currently, specialists are resorting to the following treatment options for pathology:
- Drug therapy. In the treatment of hyperthyroidism, the doctor prescribes hormonal drugs that can reduce the production of thyroid hormones. Basically, radioactive iodine is used for this, which is very toxic and is prohibited for use during pregnancy. Therefore, alternative, safer medicines for this period are prescribed. These include antithyroid drugs - "Propylthiouracil", "Tiamazole", "Metimazole" and others. It is very important at the same time that the dosage should be selected by the attending physician individually, since an incorrect dosage can provoke a miscarriage or malformations. In most cases, it is recommended to take anti-thyroid medications in the first trimester, and in subsequent their dosage should be adjusted, until the drug is completely discontinued.
- It is fully justified to prescribe sedatives that prevent psychological breakdowns, normalize sleep and help fight depressive conditions. During pregnancy, you can take medicines based on herbs, after making sure that there is no allergic reaction to the constituent components. For example, Persen, Novo-Passit. But their reception should be authorized by the attending physician.
- Surgical treatment method. In some situations, the doctor may decide on the need for an operational method of treating the pathology. This happens if conservative therapy does not bring a positive effect, in case of allergic reactions to the prescribed drugs, as well as with a large goiter or suspected malignancy of the thyroid gland. Also, an indication for surgery may be a relapse of the disease after the end of drug therapy. In most cases, this type of treatment is prescribed no earlier than the second trimester, when the risk of miscarriage is minimized. During the operation, most of the organ is excised. It is worth noting that the result of surgical intervention may be a miscarriage or premature birth.
Danger to the fetus
With hyperthyroidism and pregnancy, the consequences for the child can be quite serious. In the absence of timely treatment, the following dangerous conditions may occur:
- Early birth due to placental abruption.
- Low body weight of the child.
- Lag in development.
- Congenital hyperthyroidism.
- Violations of the nervous system of a pathological nature.
- Hypotrophy.
- Congenital organ pathology.
Dangerous complications
The consequences of hyperthyroidism and pregnancy without timely treatment can be irreparable. The most common of these are the following conditions:
- Fading pregnancy.
- Miscarriage.
- Premature birth.
- Severe toxicosis.
- Anemia.
- Placental insufficiency, since the blood flow of the pelvic organs and the placenta is disturbed.
- Bleeding.
- Detachment of the placenta, which can threaten the life of both mother and baby.
The difference between hyperthyroidism and hypothyroidism
Hypothyroidism and hyperthyroidism are equally dangerous during pregnancy. The difference is that hypothyroidism is caused by a low level of thyroid hormones, which is a serious obstacle to the conception of a child. If pregnancy has occurred, hypothyroidism can provoke the loss of a child in the early stages. When diagnosing this deviation, it is necessary to consult a specialist who will prescribe an effective therapy as soon as possible.
Prevention
Pregnancy with thyroid hyperthyroidism requires close monitoring. In addition to the implementation of the therapeutic measures prescribed by the doctor, it is necessary to carry out preventive measures, especially if there is a hereditary factor or problems with the thyroid gland work periodically.
First of all, you need to maintain iodine in the body at the proper level. Moreover, one must not allow either an overabundance of it or a lack. For this, it is important to choose the right iodine-containing drugs and food products, taking into account the region of residence and the climate. The dosage is prescribed by the attending physician, taking into account the results of the tests.
It is worth limiting the consumption of foods that depress the central nervous system. These include chocolate, spices, coffee and strong tea.
Preventive measures must be started six months before the alleged pregnancy. In this case, you must periodically take tests for hormones.
Forecast
Even when carrying out preventive measures, and then all the recommendations of a doctor, it is impossible to say with certainty how the endocrine system will work in the future. Therefore, it is very important to control the hormonal background, systematically passing all the necessary tests.
In any case, with timely diagnosis and treatment, the threat of miscarriage and premature birth can be avoided.
It is important to remember that in some cases, up to six months after the birth of the baby, a thyroid function disorder is possible.
In general, the prognosis of pregnancy with thyroid hyperthyroidism is positive, but with the condition that a pathological condition was diagnosed earlier and the necessary treatment was completed.
Conclusion
The effect of hyperthyroidism on pregnancy is very large. If untreated, irreparable complications can occur that will threaten the health and life of the woman and the child. Timely access to a doctor and the implementation of preventive measures will not allow hormonal failure to develop into a separate disease. Pregnancy with thyroid hyperthyroidism is quite possible if the necessary therapy is carried out to normalize the level of hormones.