Thyrotoxicosis and pregnancy: possible causes, symptoms, treatment, possible consequences

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

A woman experiences multiple changes in her body during pregnancy. On the hormonal side, the biggest changes occur. Due to improper rearrangement of the hormonal background, thyrotoxicosis may occur, and pregnancy will pass with pathologies.

What is this?

This disease is accompanied by an increase in the amount of hormones produced by the thyroid gland. In the blood with this disease, the amount of thyroid hormones increases sharply.

Often such a condition of women accompanies during gestation, and it is considered physiological. Thyrotoxicosis and pregnancy are common, especially in modern women.

Excess hormones most often do not affect a woman's ability to get pregnant, and fertility also does not depend on it. Substances that are produced by the thyroid gland affect many processes that accompany the proper functioning of various organ systems.

Hormones especially affect metabolism. If their number increases, then the metabolism is rapidly accelerating. Pregnancy with thyrotoxicosis of the thyroid gland passes with complications.

Shapes

Thyrotoxicosis and pregnancy most often do not “friendly get along” with each other. There are three forms of the disease:

• Easy.
• Average.
• Heavy.

Women during pregnancy are more likely to experience the first type. If the patient had problems with the thyroid gland before carrying the child, then the development of other forms is possible.

In this case, the woman can not do without hospitalization. She will require specific treatment under the supervision of gynecologists and endocrinologists.

Causes of occurrence

Doctors identify several reasons that can provoke this condition. The first cause is diffuse toxic goiter or Basedow's disease. It occurs due to autoimmune changes in the body.

This condition provokes problems with the cardiovascular system. Women may begin to increase blood pressure, there may be interruptions in the work of the heart.

Thyroid cancer has several types. There are papillary and follicular forms. An increase in the formation of the amount of hormones can lead to the development of both papillary and follicular forms of neoplasms.

Hyperthyroidism can be accompanied by the appearance of nodes of different sizes on the neck. It can significantly affect changes in the voice.

Thyroiditisaccompanied by inflammatory processes in the thyroid gland. This condition leads to the fact that the pregnancy is at risk of bearing the fetus.

If such a condition occurs due to physiological changes in the body, then by the second trimester the process of hormone production is getting better on its own, and the woman no longer experiences the discomfort that accompanies thyroiditis.

Usually in this case, the child does not undergo any changes in his development. A woman can only feel strong mood swings at this time. During the period of gestation, at first, the general symptoms of the disease may be blurred.

Very often, thyrotoxicosis of the thyroid during pregnancy is determined by chance only during the scheduled tests.

Signs

Often the disease is manifested by a sharp decrease in appetite and nausea. But such symptoms are usually found in pregnant women against the background of toxicosis, so the woman does not associate them with thyroid disorders.

If this condition is associated with physiological changes, then it goes away on its own during pregnancy with thyrotoxicosis of the thyroid gland. But when there are pathologies in the work of the gland, other symptoms begin to appear:

• Excessive sweating.
• Feeling constantly hot.
• Tachycardia.
• Goggle eye syndrome.

Due to the rapid weight gain during pregnancy, a woman may sweat more. But if this happens even in a cool room, then you should pay attention to this symptom.attention, go to your gynecologist for a consultation.

Tachycardia can accompany a pregnant woman until the baby is born. This is due to the large load on the heart. But exceeding the pulse rate of 100 beats should worry the expectant mother and refer her to the doctor.

Protruding eye syndrome appears already in the later stages of thyrotoxicosis during pregnancy. Therefore, with such a symptom, a woman should already be in the hospital under the supervision of doctors.

Diagnosis

If one of these conditions is found in a woman's he alth, then it is necessary to undergo an examination. One symptomatology will not be enough to make an accurate diagnosis. Therefore, first of all, a pregnant woman is assigned to take a blood test from a vein to determine the amount of hormones.

Then other diagnostics may follow. First of all, it is an ultrasound of the thyroid gland. In this way, you can find out what size the organ is and whether there are nodal seals on it.

What tests?

The results of laboratory diagnostics can help clarify or fully establish the correct diagnosis. Most often, a general blood test is prescribed, as well as the level of T4 and TSH in it.

To determine if there are malformations in the child, an ultrasound of the fetus is prescribed.

Treatment

If, according to the results of the entire diagnosis, it is established that the degree of the disease is mild, it is associated with physiology, then drug treatment is notrequired. It is enough just to remove nausea if it causes severe anxiety.

During pregnancy, treatment is specific. You can not prescribe L-thyroxine to a woman who is waiting for the baby to be born. Doctors recommend thyreostatics more. Often it becomes "Propylthiouracil". This drug reduces the function of the thyroid gland and is the least harmful, compared with other drugs, to the fetus.

In this case, the pregnant woman should be tested every 4 weeks to determine the amount of T4. This is the most important point during the treatment of DTG and subclinical thyrotoxicosis during pregnancy.

TSH usually does not need to be controlled and should not be changed either. When the amount of T4 produced returns to normal, then the drugs should continue to be drunk in a minimal amount.

Thyreostatics are usually used for a long time. If the woman's condition does not improve during therapy, then an operation to remove the thyroid gland may be prescribed. In terms of safety, the best time for surgery is the 2nd trimester of pregnancy.

If thyrotoxicosis takes on complex forms, then treatment can also be selected. Termination of pregnancy in this case is not recommended.

Consequences for women

Such a pathology can affect the placenta and lead to its detachment. But this is only if thyrotoxicosis acquires the following after the first stage of development. Physiological form does not pose a he alth hazardmother.

If the disease could not be contained, then an increase in hypertensive symptoms is possible. A woman's blood pressure rises strongly, and this is already a life-threatening condition. And also such a condition may require termination of pregnancy or artificial induction of labor in the later stages.

Preeclampsia is a consequence of late preeclampsia. This is a very serious condition, which is accompanied by very poor kidney function. When passing urine tests, protein is found in it. In the worst case scenario, a pregnant woman may experience convulsions.

This is a very dangerous complication that requires a caesarean section regardless of the gestational age. Also, placental abruption can be attributed to the same dangerous condition.

There is a very high risk of bleeding. This condition is very dangerous for a woman's life. In other cases, most often the uterus has to be removed.

Thyrotoxic crisis

This condition is considered the most dangerous for a woman. It develops very quickly, severe tachycardia in a pregnant woman begins, vomiting, diarrhea and tremor.

Thyrotoxic crisis often leads to fetal death. Therefore, in order to prevent such a condition, women with problems in the functioning of the thyroid gland must be observed by an endocrinologist throughout the entire period.

It is strictly forbidden to change dosages on your own or cancel the drug completely. Otherwise, harmful consequences in the future cannot be avoided.

Thyrotoxicosis during pregnancy: effects on the fetus

Thisthe disease can sometimes affect the development of the child in utero. All changes in the mother's body, especially negative ones, are necessarily reflected in the baby. Doctors point out that improper treatment of a disease in a mother during pregnancy can give the same pathology to a child.

The fetus may be delayed in development. His weight and height should be regularly monitored by ultrasound. Pathology may indicate a low level of hemoglobin, which is often observed with such a diagnosis in the mother.

The consequence of thyrotoxicosis during pregnancy can be dangerous for a child, causing his death in the last stages of pregnancy. This is the most deplorable result when carrying a fetus for a woman.

And also a newborn baby may experience thyrotoxicosis. It often goes away on its own, as the drugs that the mother drinks are prescribed, they get to the baby through mother's milk.

malformations and prevention

Severe forms often lead to violations in the child. He can develop heart disease, mental retardation, and even external mutations that lead to deformities.

Unfortunately, it is impossible to protect yourself from such a disease by preventive methods. You can only take all the tests on time to identify the disease at an early stage.

Thyrotoxicosis and pregnancy planning are closely related. Therefore, a woman who has problems with the thyroid gland must definitely undergo all the necessary examinations before conceiving a baby, and then contact an endocrinologist and warn him aboutpossible pregnancy in the near future. He will adjust the dosages and give further recommendations.

What you need to know?

It is necessary to be extremely careful when treating gestational thyrotoxicosis during pregnancy. In therapy, it is necessary to observe the constancy and regularity of the use of all drugs.

Any changes can lead to big malfunctions of the thyroid gland. In this case, surgical intervention to remove the thyroid gland cannot be avoided.

If problems in this direction are identified during pregnancy planning, then the woman should first undergo treatment. Then, after confirmation of remission, you need to wait another six months, and then just start conceiving.

In this way, you can avoid the consequences of the influence of drugs on the development of the unborn fetus. To avoid recurrence, you can perform an operation to remove the thyroid gland. It is often given to women who are nearing reproductive age and can no longer wait.

After such an operation, the expectant mother is prescribed lifelong hormone therapy. She is on the right dosage and medication. In this case, she can already become pregnant at any convenient moment.

If a woman encountered such a problem during the first time she was carrying a fetus, then after delivery it is necessary to contact the endocrinologist again and undergo an examination. Because the disease can remain and begin to actively develop.

In this condition, pregnant women alsoit is recommended to take sedatives that will help to cope with nervous tension, which occurs against the background of hormonal failure.

Thyrotoxicosis often resolves on its own by the end of pregnancy, and the symptoms disappear completely.