01 December

Hypothyroidism during pregnancy

Routine antenatal care is very important to reduce maternal and fetal complications. Hypothyroidism can adversely affect the health of the baby and the mother if not identified and treated before and during pregnancy. It is very important that a woman is screened for thyroid deficiencies ideally while she is planning to get pregnant. The baby is completely dependent on the maternal thyroid hormones especially during the first three months of pregnancy. So this may put an additional strain on the mother and could lead to further deficiency if not identified and corrected promptly.

Untreated hypothyroidism in pregnancy is associated with adverse maternal effects. During pregnancy, it is known to result in miscarriages (in early pregnancy), recurrent pregnancy losses, anemia, pre-eclampsia, gestational diabetes, abruptio-placenta, postpartum hemorrhage, increased cesarean sections due to fetal distress, and rarely myopathy and even congestive heart failure (CHF) in severe cases.

In the baby, Hypothyroidism results in preterm births, intrauterine growth restriction, intrauterine fetal demise, respiratory distress and increased perinatal mortality (PNM). In newborns, it leads to cognitive, neurological and developmental impairment. Thyroid hormone is critical for fetal brain development.

Symptoms of Hypothyroidism during pregnancy

Women complain of fatigue, lethargy, weight gain Constipation and feeling cold.

Treatment

American Thyroid Association recommends treatment of Pregnant women with clinical symptoms of Hypothyroidism with TSH more than 2.5 mIU/L and with low T4 levels or subclinical ( Patients with no symptoms) hypothyroidism with positive antibodies. It also recommends regular TSH monitoring of euthyroid ( Thyroid hormone levels are normal, but they have antibodies) Pregnant women throughout pregnancy. Subclinical Hypothyroidism in pregnant women who have not been treated initially should be monitored every 4 weeks with serum TSH and FT4, until 16 to 20 weeks of gestation and at least once between 26 to 32 weeks.

Endocrine society encourages TSH in “high risk” individuals and low dose thyroxine to target TSH to <2.5mIU/l. It recommends repeating the screening in the second trimester if initial screening is normal. Adequacy of hypothyroid treatment will be monitored by repeat TSH after 6 weeks of initiation of treatment and medication will be adjusted. One should try to take the thyroid medication 1 to 1.5 hours before food or 4 to 5 hours after food and avoid taking thyroid medications along with your pre-natal vitamins as it can interfere with its absorption.

Source: National Guidelines for Screening of Hypothyroidism during Pregnancy, India.

MoHFW, Government of India


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We have put together weekly developments during pregnancy. These articles are only for information. Every pregnancy is different and every woman's experience may be different. We also have articles relating to women's health, infertility and plan to add information about newborn care. Through the blogs, videos and our online consultation services, we are trying to empower mothers (as well as soon-to-be-moms) with health information which is easily understandable. Our mission is to help mothers have a happy pregnancy and a very happy postpartum experience. 

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Pregnancy brings a new meaning to the concept of beauty to a woman. It is a period of immense joy, excitement and anxiety. The feeling of carrying a little soul within you is beautiful.

Last modified on Monday, 06 August 2018 11:42
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