The thyroid gland and pregnancy: the effect of hormones on the course of pregnancy, norms and deviations, methods of treatment, prevention

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

Pregnancy is one of the most joyful periods in the life of every woman, but not everything always goes as we would like. When carrying a child, a woman's body undergoes serious changes, in particular, in the thyroid gland.

This changes the very structure of the body and the ratio of hormones produced. It is very important to find out if changes in the thyroid gland and pregnancy are compatible, and how you can endure and give birth to a he althy baby.

Pregnancy planning for thyroid problems

The possibility of conception is influenced by many different factors that must be taken into account. The state of the thyroid gland plays an important role in planning pregnancy. Violation of the functioning of this organ can have a significant impact on the speed of puberty, cause menstrual irregularities and lead to infertility or spontaneous miscarriage.

UIn women, thyroid pathologies are much more common than in men, so when planning a pregnancy, you must make sure that there are no diseases. To do this, it is enough to conduct laboratory diagnostics, that is, take blood tests for hormones.

Pregnancy after surgery

Pregnancy after removal of the thyroid gland is possible only two years after the operation. During this time, there is a complete rehabilitation and restoration of normal hormonal balance.

A woman with a removed thyroid gland needs to be on hormones all her life. In this case, pregnancy planning is required with a mandatory consultation with an endocrinologist. The doctor will observe the woman until delivery.

However, it is worth noting that in the absence of a thyroid gland, the question of terminating a pregnancy may become more than once.

Thyroid condition after pregnancy

Drowsiness, psychological discomfort and weakness in a woman after delivery are often attributed to postpartum depression. However, all these violations can also occur due to impaired functioning of the thyroid gland. It is worth noting that often after pregnancy, the thyroid gland begins to work much more actively, and against this background, thyroiditis develops.

During the period of carrying a baby, the immunity weakens so that the fetus can be fixed normally. After childbirth, the immune system is restored and often even in a very sharp form. Antibodies are produced in large quantities and begin to actively attack their own cells. Then, in addition tothyroid gland, other organs also suffer.

Postpartum thyroiditis is the result of an overactive immune system. The risk group is mainly women with diabetes or already having a history of this disease. Thyroiditis can gradually turn into hyperthyroidism or hypothyroidism.

In general, thyroid treatment after pregnancy is not required. The doctor can only prescribe beta-blockers that normalize the heartbeat. When hypothyroidism occurs, thyroid drugs are prescribed that will be safe for a newborn baby.

How the thyroid affects pregnancy

The hormones of this organ play a very important role, as they regulate all types of metabolic processes, the growth and maturation of cells, tissues and organs. The thyroid gland during pregnancy functions with a double load, since this organ takes part in the same processes in the fetus. Provided there is a sufficient amount of hormones in the woman's blood, the normal development of all major systems in a child is possible.

During pregnancy, the thyroid gland and parenchyma increase in size so that hormones are produced in much greater quantities. At about 12-17 weeks, the fetal thyroid begins to form, but it is still very small, so the baby still needs maternal hormones.

What diseases can be

Thyroid abnormalities and pregnancy are closely related. Some pathologies begin to develop as a result of hormonal changes that occur inbody, and the harmful effects of external factors. Among the main diseases of the thyroid gland, the following should be distinguished:

• hypothyroidism;
• hyperthyroidism;
• euthyroidism;
• chronic thyroiditis;
• malignant tumor.

Pregnancy with hypothyroidism of the thyroid gland is quite difficult, since such a pathology is characterized by insufficient iodine content in the body and subsequent hormone deficiency. A similar pathological condition sometimes occurs even before pregnancy, which is why when planning the conception of a child, it is necessary to undergo a complete examination.

Among the main manifestations of such a state, the following should be highlighted:

• severe fatigue;
• loss of appetite;
• brittle hair and nails;
• weight gain;
• shortness of breath;
• puffiness;
• dry skin.

If all these signs occur, the doctor should conduct an additional examination. If the diagnosis is confirmed, then it is necessary to undergo a course of treatment. To compensate for the lack of hormones, replacement therapy is required. It is also carried out during the period of bearing a child, since such a violation significantly increases the risk of miscarriage, premature birth or fetal fading.

A significant drop in hormone levels can lead to deafness, mental retardation and strabismus in a newborn baby.

Thyroid disease and pregnancy are very closely related. Hyperthyroidism is quite common. This condition is physiological in nature, since basically the thyroid hormone is always increased during pregnancy so that it can be replenished for the fetus. However, in some cases, the doctor perceives the excessive functioning of this organ as a deviation.

The most common manifestation of hyperthyroidism is nodular goiter. The disease is accompanied by the formation of large nodular formations. To avoid a harmful effect on the baby's condition, the doctor corrects hormones in the blood.

The entire period of bearing a baby passes under the strict control of an endocrinologist. Basically, no operation is performed. Intervention is indicated only if the formation squeezes the trachea, disrupting normal breathing. Among the main symptoms to highlight:

• drastic weight loss;
• temperature increase;
• insomnia;
• irritability;
• pressure increase;
• muscle weakness.

The consequences of hyperthyroidism can be very dangerous late preeclampsia, fetal anomalies, as well as low birth weight. If the disease was detected in a timely manner, then the probability of a he althy baby being born is very high.

Euthyroidism is a borderline condition, which is characterized by the growth of thyroid tissue in the form of a diffuse increase in nodes in size with normal levels of thyroid hormones. This disruption is temporary. Usually, against the background of the occurrence of such a pathology, dangerouschanges in this body.

Among the main features to highlight:

• pain in the neck;
• deterioration of sleep;
• psycho-emotional overstrain;
• feeling like a lump in the throat;
• increase in the size of the affected organ.

To cope with such a violation, the doctor prescribes iodine-containing drugs. If conservative therapy does not bring the desired result, and cyst formation also occurs, then surgical intervention with a biopsy is required.

Malignant neoplasm is not considered an absolute indication for abortion. When a tumor is detected, the doctor prescribes a biopsy. A puncture is especially important if the size of the neoplasm is more than 2 cm. The operation can be performed in the 2nd trimester of pregnancy. If the tumor is detected in the 3rd trimester, then the intervention is carried out only after delivery. Rapidly progressive forms of cancer require urgent surgery regardless of the gestational age.

Chronic autoimmune thyroiditis occurs as a result of the formation of antibodies to one's own cells. In this case, the immune system begins to gradually destroy the thyroid gland. Pathology is hereditary or provoked by gene mutations. Such a violation negatively affects the body of a woman. It is worth noting that without timely treatment, such a thyroid disease and pregnancy are incompatible.

Causes of occurrence

In pregnancy, the thyroid gland has a very importantfunctional significance, and any problems with this organ negatively affect the well-being of the woman and the development of the fetus. The cause of problems with the thyroid gland during the period of bearing a child can be a sharp change in hormonal levels. This is especially acute during multiple pregnancy, as it can provoke hypothyroidism. The cause of this condition may be increased production of placental hormones, which lower the level of TSH in the blood. In addition, provoking factors should include such as:

• frequent and indomitable vomiting;
• bubbly skid;
• trophoblastic disease;
• early preeclampsia.

Hyperthyroidism and its symptoms can trigger the appearance of neoplasms in the thyroid gland. They require close attention from endocrinologists, as they can degenerate into a malignant tumor.

Main symptoms

If the activity of the thyroid gland during pregnancy is increased or decreased, then the woman has certain signs.

Among the main symptoms of the course of the pathology, it is necessary to highlight:

• general malaise;
• apathy;
• absent-mindedness;
• strong weakness;
• facial swelling;
• tearfulness;
• violation of the functioning of the gastrointestinal tract;
• excessive sweating.

With a lack of hormones in the body, a woman has problems with conception. Often they make a disappointing diagnosis - infertility.

Diagnostics

It is worth noting that the diagnosis of the state of the thyroid gland duringpregnancy has its own specific characteristics.

In particular, the doctor prescribes:

• tests for hormone levels;
• biopsy;
• ultrasound diagnostics.

Required to conduct thyroid tests during pregnancy. They help determine the level of thyroid hormones and antibodies. At the same time, it must be remembered that in the first 3 months of bearing a child, the norm is a decrease in the amount of TSH and an increase in T4.

Ultrasound diagnostics is carried out for the study of nodular formations. If the size of the neoplasm exceeds 1 cm, then the doctor additionally prescribes a puncture biopsy. Radioisotope techniques and scintigraphy are not used, since radiation adversely affects the condition of the fetus, regardless of the gestational age.

Hormon norms and deviations

If thyroid hormones are elevated during pregnancy, then this is considered the norm, especially in the early stages, since it is maternal hormones that enter the fetus. The need for iodine increases from 150 mcg to 250 mcg per day.

The norms of thyroid hormones during pregnancy in each trimester are different, which must be taken into account when diagnosing. It is worth noting that the level of TSH does not change and should be 0.2-3.5 μIU / ml. Free T4 in the first trimester should be 10.3-24.5 nmol/l, and in the 2nd and 3rd trimester this figure should normally be 8.2-24.7 nmol/l.

If there are deviations from these indicators, be sure to visitendocrinologist, who, based on the results of the study, will select the method of therapy. It should be noted that tests are prescribed only if there are deviations in the functioning of this body. They are not included in the standard list of examinations of a pregnant woman.

Providing treatment

If there is a deviation from the norm of the thyroid gland during pregnancy, then timely treatment is generally required. Therapy of diseases of the endocrine system has certain features, since it is important to take into account the changes that occur in the body of the expectant mother.

Elevated levels of globulin in the blood greatly complicates the diagnosis of hormonal levels and diagnosis. High levels of thyroxin lead to a change in the functioning of many organs, which must also be taken into account during therapy.

In the presence of hormonal changes in the blood, an endocrinologist may prescribe synthetic thyroxin. With hyperthyroidism, Propicil is prescribed. This drug is used in the presence of toxic diffuse goiter and affects the cells of the thyroid gland. It reduces the growth of abnormal cells, and also eliminates symptoms such as tremors, convulsions, burning in the throat, weakness and chills.

In the presence of endocrine problems in pregnant women, iodine-containing medications are required, which the doctor selects separately in each case. In addition, you can additionally take biological supplements.

When malignant cells are detected, an examination is often requiredoperations. It is worth noting that thyroid problems can lead to various disorders and even the birth of a dead baby.

Possible Complications

Even minor changes in the work of this body can lead to very serious complications during childbearing, delivery and the postpartum period. The thyroid gland affects the possibility of conception, as well as the psycho-emotional state of a woman.

Among the most common complications we should highlight:

• miscarriage;
• arterial hypertension;
• high blood pressure;
• preterm birth;
• heavy uterine bleeding after delivery;
• placental abruption.

In addition, a woman with thyroid disease often gives birth to mentally retarded children, as well as those with developmental disabilities. Significantly increased risk of fetal freezing.

After giving birth, a woman may experience prolonged depression. This condition may be due to an acute lack of iodine in the body.

Prophylaxis

The thyroid gland and pregnancy are closely related, which is why it is very important to prevent the occurrence of pathologies of this organ. Endocrine pathologies are often found in women of reproductive age, and every year their number is only growing. That is why, before planning a pregnancy, it is recommended to conduct a comprehensive diagnosis to determine the features of the functioning of this organ. This will allow timely detection of the presence of pathology andtreat.

The set of preventive measures includes prescribing iodine-containing drugs to pregnant women. You need to take them from the first weeks and up to delivery. Additional intake of iodine in the body will help reduce the likelihood of goiter and normalize hormonal levels.

For prevention, women are advised to consume iodized s alt. The menu must also include foods high in iodine. It is important to exclude harmful, spicy, fatty, fried foods from your diet. It is imperative to maintain weight at the required level, since the appearance of excess weight negatively affects the state of the thyroid gland. The main thing is to obey the doctor and fulfill all his appointments.