Autoimmune thyroiditis during pregnancy: symptoms, treatment, effects on the fetus

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

For the first time, such a disease as autoimmune thyroiditis was described by the Japanese doctor Hashimoto Hakaru, who, in fact, discovered this pathology. AIT of the thyroid gland - what is it? Pathology occurs, as a rule, in women who are in position. In 15% of cases, it develops during pregnancy, and in 5% - in the near future after the baby is born. The disease is most dangerous for young and middle-aged women.

Pregnancy and illness

Autoimmune thyroiditis of the thyroid gland - what is it? This term refers to a disease that leads to infiltration of thyroid tissue. In PIT, the thyroid gland cannot continue to produce the right amount of hormones, and due to the release of autoantibodies as a result of inflammation, it begins to be perceived by the body as a threat.

During the bearing of a child, this organ, during its normal functioning, secretes a sufficient amount of thyroid hormones and takes part in the formation of the embryo. AIT during pregnancy is an extremely dangerous condition. It can negatively affect not only the woman, but also the unborn child. Doctors say that pregnancy and AIT are unacceptable at the same time. However, if a woman has time to determine the presence of a pathology at an early stage of its development, she will be able not only to maintain a pregnancy, but also to give birth to a strong baby with well-developed organs.

Reason for development

AIT of the thyroid gland - what is it? What are the reasons for development? In most cases, thyroiditis develops against the background of autoimmune diseases in a woman's body.

Specialists also report its genetic origin. If a close relative has a similar pathology, then the risk of passing it on by inheritance increases significantly. There are also many other causes of autoimmune thyroiditis during pregnancy:

1. If a virus or infection has entered the woman's body.
2. When the body's immune defenses decrease.
3. As a result of exposure to radiation rays, prolonged negative exposure to ultraviolet radiation or excessive insolation.
4. Iodine in autoimmune thyroiditis during pregnancy is either not enough or too much is produced.
5. Poor ecology in the place of residence or lack of selenium in the soil.
6. Emotional overload, nervous breakdowns,constant mood swings.
7. When the thyroid gland is damaged.

Additional factors leading to the appearance of the disease during pregnancy most often include alcohol abuse, smoking, maintaining an unhe althy lifestyle, especially if the fact of a genetic predisposition is recognized. Pathology can also affect a whole mass of people living in one area in which iodine deficiency is noted.

Symptoms of disease damage

Symptoms and treatment of autoimmune thyroiditis are two interdependent processes. Only by noticing signs of illness and consulting a doctor in time, you can draw up a comprehensive treatment plan that will help to cope with the problem and prevent dangerous complications.

It should be remembered that thyroiditis is quite difficult, since during the bearing of a child it almost does not make itself felt, and the woman associates all the symptoms that appear with natural, completely normal for her current situation. It is for this reason that the disease is most often determined by chance after an unscheduled trip to the doctor.

It is very easy to determine its presence by palpation of the neck, it feels like a seal of an unnatural shape. If such a formation is found, it is important to immediately go for a consultation with a specialist.

In a woman with autoimmune thyroiditis during pregnancy in the first trimester, the production of thyroid hormones increases significantly, which is considered absolutely normal. Further, the condition returns to normal and it begins to seem that the disease has passed. But immediately after the birth of the childpathology manifests itself even more intensely. To prevent such an outcome, it is important to control the disease not only throughout pregnancy, but also after it.

Planning pregnancy when sick

The impact of autoimmune thyroiditis on the fetus can be very different, so it is very dangerous to ignore such a pathology. The last, final stage of the disease is hypothyroidism, during which the amount of hormones secreted by the thyroid gland in the body is rapidly decreasing. This often leads to infertility, because due to the lack of these hormones, the follicles do not fully mature, and ovulation does not happen according to plan. It becomes impossible to conceive a child until the problem is fixed.

Pregnancy planning for AIT can be effective only in case of uetireosis, when the thyroid gland secretes a sufficient amount of hormones. The doctor prescribes the intake of these drugs to the woman. It is important to remember that an overdose of hormonal drugs is just as dangerous as thyroiditis itself.

IVF treatment

Before thinking about IVF, experts advise once again to make sure that this particular disease has led to infertility. There is no need to think that the IVF method will help get rid of all the difficulties, since the success of the entire procedure will directly depend on the he alth of the woman. It is for this reason that without therapeutic measures in AIT, in vitro fertilization will not lead to any effect. If the pathology has managed to develop to the stage of hypothyroidism, there is no IVF at allmeaning, since fertilization will not occur.

But there are also cases when IVF is possible when autoimmune thyroiditis is detected, for example, if the disease is controlled by a specialist and treated. To do this, you need to go to an appointment with an endocrinologist, who will carry out all the necessary diagnostic measures and prescribe therapy. It is important to undergo treatment, following all the recommendations and instructions of specialists. It is necessary to prepare for the procedure only after the permission of the endocrinologist, when it will be clear that all the functions of the reproductive system have returned to normal and can work as before. The restored hormonal background will help not only to conceive a child, but also save the pregnancy itself.

How does the disease affect the embryo?

Is the effect of autoimmune thyroiditis during pregnancy on the fetus dangerous? The disease has a direct impact on the bearing of a child and may begin to manifest itself after many years. During pregnancy, the thyroid gland in a woman is one of the most important organs, since it is she who is responsible for the proper development of the embryo in the womb.

At the moment of bearing a child, the thyroid gland begins to naturally produce thyroid hormones, which are important for the baby in large quantities. Thyroiditis directly affects this function and as a result leads to a lack or excessive amount of the hormone produced, which in turn affects the condition of the child and the woman herself.

Signs

Diseaseduring pregnancy, it can report itself with different symptoms. Moreover, each woman can determine their different levels in the body. According to general clinical guidelines for autoimmune thyroiditis, special attention should be paid to the following symptoms:

• appearance of dry skin;
• formation of extensive edema;
• problems with the speech apparatus, severe fatigue, drowsiness present;
• beginning of hair loss;
• mood swings;
• many feel a lump in their throat and also complain of trouble swallowing food;
• pain in the neck.

The described symptoms do not tell exactly about the presence of AIT in the body of a woman. But when they are detected, it is important to immediately go to the doctor. It is important to pay special attention to the type and form of the disease.

What varieties are there?

The disease is divided into atrophic (reduction of the thyroid gland) and hypertrophic (increase) form. If we talk about the stages of autoimmune thyroiditis, then it is more reasonable to present the following classification:

1. Spicy. The most rare form of the disease, which occurs due to the penetration of pathogenic microorganisms into the thyroid gland. In this case, therapeutic measures guarantee a favorable outcome when timely assistance is provided.
2. Chronic thyroiditis manifests itself as a hereditary disease. This form begins to develop actively after autoantibodies secreted from the thyroid gland with an inflammatory process,kill thyroid hormones. For a long time (two years), the pathology develops, as a rule, without symptoms, does not manifest itself. Therefore, it is found most often during pregnancy. Thyroiditis leads to an increase in the size of the organ and the appearance of unpleasant symptoms in a woman.
3. Postpartum. The reason for the appearance of this form of AIT is most often a strong hormonal effect on the immune system. The disease begins to report itself after 3-4 months after the birth of the child and develops quite quickly. The main symptoms characteristic of this condition include severe fatigue, feeling unwell, sweating or chills, sleep problems, and even tachycardia. Women often suffer from depression and mood swings.

What are the consequences?

If you do not start timely treatment and do not control the development of pathology, then as a result, any of its forms will affect the development of the fetus and even lead to mental retardation of the child immediately after birth. This is primarily due to the fact that aggressive autoantibodies deform the structure of the child's thyroid gland and lead to hypothyroidism.

Also, a mother's lack of thyroid hormones causes a delay in the formation of the child's nervous system, which additionally negatively affects his intellectual abilities in the future.

Consequences during pregnancy

The disease is a particular danger not only for the baby developing in the womb, but alsofor the mother herself. The consequences of autoimmune thyroiditis during pregnancy can be as follows:

• problems with labor activity;
• postpartum thyroiditis;
• diseases of the cardiovascular system;
• exhaustion of the body;
• early birth;
• development of placental insufficiency (as a result, spontaneous abortion occurs);
• stillbirth or death of a child in the womb.

To avoid this, it is important to diagnose the disease in time, and then control its development and follow all the instructions of the attending physician.

Diagnostic measures

Difficulties in diagnosing autoimmune thyroiditis arise because the disease has vague signs, and many women rarely pay any attention to them. Currently, three diagnostic methods are widely used for urgent and planned examinations:

1. Palpation, which is performed in the office of an endocrinologist. It is the very first way to diagnose a disease, with the help of which a specialist identifies all deviations from the normal size of the thyroid gland.
2. Carrying out a blood test. It is prescribed after examination by a doctor and helps to determine the amount of hormones and autoantibodies in the thyroid gland.
3. Ultrasound helps to get complete information about the state of the thyroid gland. It is also used to control the condition of a child developing in the womb. Most often, ultrasound with such a disease is performed every eight days.

When autoimmune thyroiditis is detected in the bodypregnant diagnostic measures should be carried out regularly. Additionally, a biopsy of the thyroid gland may be prescribed - tissue sampling for a detailed examination. All diagnostics during childbearing make it possible to decide on a more optimal method of treatment and, in which case, correctly correct it.

Treatment measures

The main difficulty in the treatment of the disease is that during the gestation of the fetus, many hormonal drugs, any surgical intervention and traditional medicine are contraindicated. But in an emergency, in clinical recommendations, autoimmune thyroiditis is allowed to be treated with medications. This refers to situations where the harm from them is less than from the disease itself.

Self-treatment in this case is strictly prohibited. All activities are carried out by an endocrinologist, selecting an individual treatment regimen for each woman:

• taking medication;
• phytotherapy;
• operation.

Another fairly effective method to overcome the disease, common in other countries, is homeopathy. Its use is permitted with the consent of a specialist. Homeopathy is not official medicine in Russia.

Can autoimmune thyroiditis and pregnancy "coexist"? The reviews say that it is important to treat your condition and the situation as a whole as carefully and responsibly as possible, since it is quite difficult to bear a child with an illness.