Pregnancy is a special period in a woman's life. Significant changes are taking place in the body, which also relate to the endocrine system, because hormones are directly involved in the conception and proper development of the fetus. It is necessary to keep their level in the body of a pregnant woman under control, because even the slightest deviation from their norm can lead to serious consequences. One of the dangerous disorders in the work of the endocrine system is considered to be hyperthyroidism during pregnancy. What it is and how it threatens the 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 increases in the blood, as a result of whichmetabolic processes are accelerated. It happens that such a pathology occurs during pregnancy, which can cause serious disturbances in the development of the child, since an excess of hormones can be supplied to him through the placental circulation. Due to the fact that hyperthyroidism during pregnancy can have a rather serious effect on the fetus, it is extremely necessary to control the hormonal background both during pregnancy planning and during the period of bearing the baby.
Causes of pathology
The work of the thyroid gland affects the functioning of the whole organism as a whole. During the bearing of a child, 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 increased production of T3 and T4 is affected by the hormone hCG, which indicates the presence of pregnancy. It also has a stimulating effect on the tissues 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.
Thyroid hormone abnormalities also occur due to the following diseases:
- Graves' disease. This pathological condition is the culprit in the development of hyperthyroidism in most cases. It is an autoimmune disease in whichthe body produces certain antibodies that provoke an increased production of thyroid hormones.
- Tumor formations of the pituitary gland.
- Toxic adenoma, in which there is an increased functioning of someone in a particular area of the thyroid gland.
- Malignant tumors 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 are viral infections.
- Taking certain medications, including hormones.
- Disorders of the immune system.
- Bubble skid. A rare pathology of the fetal egg, which occurs due to insufficient stimulation of the thyroid gland by the hCG hormone.
- Wrong diet.
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 is not yet functioning, so the maternal gland takes over its role. At the same time, T3 and T4 can increase by 2 times. This is a normal condition that does not require treatment. As a rule, after a certain time, the level of hormones returns to normal. It happens that in some women the concentration of thyroid hormones exceeds the norm, which is permissible during pregnancy, while TSH decreases. There is a development of transient gestational hyperthyroidism during pregnancy, which is accompanied by all the unpleasant symptoms.
- Acquired hyperthyroidism, the causes of which are pathologies of the thyroid gland. This type of pathology includes diffuse goiter.
- Acquired hyperthyroidism, which occurs with improper hormone therapy.
Modern classification identifies three types of this pathology:
- Primary hyperthyroidism, the main cause of which is malfunction of the thyroid gland.
- Secondary is caused by 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. Manifested by 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 bearing a baby, but also before pregnancy.
The most common symptoms of high thyroid hormones include:
- Unreasonable weight gain or low weight gain.
- Psychologicaldisorders - depression, nervousness, anxiety.
- Jumps in blood pressure.
- Increased body temperature.
- Irregular heart rhythms.
- Increased heart rate.
- Drowsy.
- Excessive sweating.
- Heat intolerance.
- Doubling objects.
- Shortness of breath.
- Slight tremor.
- Stool disorder.
- Enlarged thyroid.
- Pug-Eyed.
- Weakness.
- Intense thirst.
- Muscle fatigue.
- Frequent urination.
- Nausea and vomiting.
- Hair loss.
In more advanced stages of the disease, conditions such as:
- Dry skin.
- Swelling of the eyelids.
- Screw in the eyes.
- Stool disorders.
- Feeling pain in the navel.
- Liver damage.
- The most dangerous condition is a thyrotoxic crisis, which can threaten not only the he alth, but also the life of a woman and a child.
Since the signs of hyperthyroidism during pregnancy can easily be confused with the typical manifestations that occur during childbearing, the diagnosis of pathology often occurs quite late. Therefore, do not neglect the appointments of the attending physician and take all the necessary tests on time.
Diagnosis
Since hyperthyroidism during pregnancy has a very serious effect on the fetus, it is very important to diagnose the pathology in a timely manner. This is especially important for those women who have before conceptionhad thyroid problems or any of the above symptoms.
Let's take a closer look at possible diagnostic measures.
- First of all, you need to visit an endocrinologist who will conduct an examination and collect an anamnesis of the disease, where he will clarify the presence of a hereditary factor, early cases of hormonal imbalances, nutritional habits, and more.
- Next, a venous blood test for thyroid hormones is prescribed.
- General analysis of urine and blood, which can indicate the presence of an inflammatory process in the body.
- Blood clotting test.
- Ophthalmic research.
- ECG.
- Thyroid ultrasound.
- Sometimes an MRI or CT may be needed.
- Thyroid biopsy.
- The child's condition is assessed by Doppler ultrasound.
Treatment
Hyperthyroidism during pregnancy is treated 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 cause significant harm to the fetus.
Currently, specialists resort 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 foruse during pregnancy. Therefore, alternative, safer drugs for this period are prescribed. These include antithyroid drugs - Propylthiouracil, Thiamazole, Metimazole and others. It is very important at the same time that the attending physician selects the dosage on an individual basis, since an incorrect dosage can provoke a miscarriage or malformations. In most cases, antithyroid drugs are recommended to be taken in the first trimester, and in subsequent trimesters, their dosage should be adjusted, up to the complete withdrawal of the drug.
- The prescription of sedatives is fully justified, which prevent psychological breakdowns, normalize sleep and help fight depression. During pregnancy, you can take herbal medicines, after making sure that there is no allergic reaction to the components included in the composition. For example, "Persen", "Novo-passit". But they must be approved by the attending physician.
- Surgical method of treatment. In some situations, the doctor may decide on the need for an operative method of treating the pathology. This happens if conservative therapy does not bring a positive effect, if allergic reactions occur to the prescribed drugs, as well as if the goiter is large or a malignant thyroid gland is suspected. Also, an indication for surgery may be a relapse of the disease after the end of drug therapy. In most cases, this typetreatment is prescribed no earlier than the second trimester, when the risk of miscarriage is minimized. During the operation, a large part of the organ is excised. It is worth noting that a miscarriage or premature birth may result from surgery.
Danger to fetus
With hyperthyroidism and pregnancy, the consequences for the baby can be quite serious. In the absence of timely treatment, the following dangerous conditions may occur:
- Premature birth due to placental abruption.
- Low weight baby.
- Developmental delay.
- Congenital hyperthyroidism.
- Disorders of the nervous system of a pathological nature.
- Hypotrophy.
- Congenital organ pathologies.
Dangerous Complications
The consequences of hyperthyroidism and pregnancy without timely treatment can be irreparable. The most common of these are the following states:
- Pregnancy fading.
- Miscarriage.
- Premature birth.
- Severe toxicosis.
- Anemia.
- Placental insufficiency, as the blood flow of the pelvic organs and placenta is disturbed.
- Bleeding.
- Detachment of the patient, which can threaten the life of both mother and child.
The difference between hyperthyroidism and hypothyroidism
Hypothyroidism and hyperthyroidism during pregnancy are equally dangerous. The difference is that hypothyroidism is caused by low levels of thyroid hormones, which is a serious barrier to conception.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 get the advice of a specialist as soon as possible, who will prescribe an effective therapy.
Prevention
Pregnancy with hyperthyroidism requires careful monitoring. In addition to performing the therapeutic measures prescribed by the doctor, it is necessary to take preventive measures, especially if there is a hereditary factor or problems with the thyroid gland periodically occur.
First of all, you need to maintain iodine in the body at the proper level. Moreover, neither its overabundance nor its deficiency should be allowed. To do this, it is important to choose the right medicinal iodine-containing drugs and food products, taking into account the region of residence and 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 should be started six months before the expected pregnancy. In this case, you need to periodically take tests for hormones.
Forecast
Even with the implementation of preventive measures, and then all the doctor's recommendations, 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 by systematically passing all the necessary tests.
In any case, with timelydiagnosis and treatment can avoid the threat of miscarriage and premature birth.
It is important to remember that in some cases, within six months after the birth of a child, a thyroid disorder is possible.
In general, the prognosis of pregnancy with hyperthyroidism of the thyroid gland is positive, but with the condition that the pathological condition was previously diagnosed and the necessary treatment was completed.
Conclusion
The impact of hyperthyroidism on pregnancy is very high. If left untreated, irreparable complications can occur that will threaten the he alth and life of a woman and a child. A timely visit to a doctor and the implementation of preventive measures will not allow a hormonal failure to develop into a separate disease. Pregnancy with hyperthyroidism of the thyroid gland is quite possible if the necessary therapy is carried out to normalize hormone levels.
