Hypothyroidism

Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone, is the most common form of thyroid disease. Symptoms include fatigue, depression, forgetfulness, irregular menses and weight gain.


• Treatment for hypothyroidism during pregnancy is the same as for non-pregnant women – a synthetic form of thyroid hormone called levothyroxine.
• Prior to becoming pregnant, women on levothyroxine should see their doctor to make sure that they are on an appropriate dose.
• Women who are on levothyroxine prior to becoming pregnant typically need to increase the dose early in the first trimester by approximately 50 percent.
• Untreated, or inadequately treated, hypothyroidism is linked to spontaneous miscarriage, preterm delivery, and decreased IQ in the unborn child.
• Children born with congenital hypothyroidism (no thyroid function at birth) may have severe developmental abnormalities if not appropriately identified and treated.
• In the U.S., ALL newborns are screened for congenital hypothyroidism.
• Mandatory screening of newborns for congenital hypothyroidism and early treatment has prevented mental retardation.
• Eight percent of all women develop postpartum thyroiditis. Postpartum thyroiditis occurs in the first year after delivery and consists of hyperthyroidism followed by hypothyroidism.

Hyperthyroidism

Hyperthyroidism is a condition causing the gland to produce too much thyroid hormone. Symptoms include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems and eye irritation.

• Hyperthyroidism may be difficult to diagnose during pregnancy because the symptoms are difficult to distinguish from normal pregnancy.
• Graves’ disease is a type of hyperthyroidism; it is an autoimmune disorder that is genetic.
• Women treated for Graves’ disease typically have their medicine decreased during pregnancy.
• Women with pre-existing Graves’ disease frequently have a flare of the disease postpartum.
• The chance of developing new onset Graves’s disease is increased during the first year postpartum.
• Inadequately treated hyperthyroidism can result in early labor and a serious complication called “pre-clampsia.”

Screening for Thyroid Disease During Pregnancy

The American Thyroid Association recommends that the following high-risk women be screened for thyroid disease either prior to becoming pregnant, or as soon as feasible once a woman becomes pregnant:

• Women with a history of thyroid disease or thyroid surgery.
• Women with a family history of thyroid disease.
• Women with a goiter.
• Women with known thyroid antibodies.
• Women with symptoms or clinical signs of hyperthyroidism or hypothyroidism.
• Women with Type I diabetes mellitus.
• Women with other autoimmune disorders.
• Women with infertility.
• Women with previous therapeutic head or neck irradiation.
• Women with a history of miscarriage or preterm delivery.

Source-Newswise
SRM