A woman experiences multiple changes in her body during pregnancy. On the hormonal side, the biggest changes are taking place. Due to improper adjustment of the hormonal background, thyrotoxicosis can occur, and pregnancy will go with pathologies.
What it is?
This disease is accompanied by an increase in the amount of hormones that the thyroid gland produces. In the blood with this disease, the amount of thyroid hormones increases sharply.
Often this condition of women accompanies during gestation, and it is considered physiological. Thyrotoxicosis and pregnancy are a common occurrence, especially in modern women.
Excess hormones often do not affect a woman’s ability to become pregnant, and fertility also does not depend on him. 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 is complicated.
Forms
Thyrotoxicosis and pregnancy are most often "not friendly" with each other. There are three forms of the disease:
Women during pregnancy are more likely to encounter the first type. If the patient had problems with the thyroid gland before bearing the child, then other forms may develop.
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 Bazedov’s disease. It occurs due to autoimmune changes in the body.
This condition provokes problems with the cardiovascular system. In women, blood pressure may begin to increase, interruptions in the work of the heart can occur.
Thyroid cancer has several types. There are papillary and follicular forms. An increase in the formation of hormones can lead to the development of both papillary and follicular neoplasms.
Hyperthyroidism may be accompanied by the appearance of nodes of different sizes on the neck. It can significantly affect changes in voice.
Thyroiditis is accompanied by inflammatory processes in the thyroid gland. This condition leads to the fact that pregnancy becomes at risk of bearing the fetus.
If this condition occurs due to physiological changes in the body, then by the second trimester the process of hormone production is independently adjusted, and the woman no longer experiences unpleasant sensations that accompany 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 can be lubricated.
Very often thyrotoxicosis 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 a woman does not connect them with thyroid dysfunction.
If this condition is associated with physiological changes, then it independently passes 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 of constant heat.
- Tachycardia.
- Bulging eye syndrome.
Due to abrupt 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, go to your gynecologist for a consultation.
Tachycardia can accompany a pregnant woman until the baby is born. This is due to the heavy load on the heart. But exceeding the pulse rate of 100 beats should worry the expectant mother and send to the doctor.
Bulging eye syndrome appears already in the late stages of thyrotoxicosis during pregnancy. Therefore, with this symptom, a woman should already be in a hospital under the supervision of doctors.
Diagnostics
If one of these conditions is found in the health of a woman, then an examination is necessary. Symptoms alone for an accurate diagnosis will not be enough. Therefore, first of all, a pregnant woman is prescribed to take a blood test from a vein to determine the amount of hormones.
Then another diagnosis may follow. First of all, this is an ultrasound of the thyroid gland. In this way, you can find out how large the organ is and whether there are nodal seals on it.
What kind of tests?
Laboratory diagnostic results 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 whether there are malformations of 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 not required. It is enough to remove nausea, if it causes great concern.
During pregnancy, treatment is specific. You can not prescribe L-thyroxine to a woman who is waiting for the birth of a baby. Doctors recommend thyreostatics more. Often it becomes "Propylthiouracil." This drug reduces the function of the thyroid gland and the least harm to the fetus compared to other drugs.
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 DTZ and subclinical thyrotoxicosis during pregnancy.
The amount of TSH usually does not need to be controlled, and it is also not worth changing it. When the amount of produced T4 returns to normal, then the drugs should continue to be drunk in a minimum amount.
Thyrostatics are usually used for a long time. If the woman's condition does not improve during therapy, an operation to remove the thyroid gland may be prescribed. For safety, the best moment for surgery is the 2nd trimester of pregnancy.
If thyrotoxicosis takes complex forms, then treatment can also be selected. Pregnancy to interrupt in this case is not recommended.
Implications for a Woman
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. The physiological form does not pose a threat to the health of the mother.
If the disease could not be restrained, then an increase in hypertensive symptoms is possible. The woman's blood pressure rises greatly, and this is a life-threatening condition. And also this condition may require termination of pregnancy or artificial induction of labor in the later stages.
Preeclampsia is a consequence of late gestosis. This is a very serious condition, which is accompanied by very poor kidney function. When passing urine tests, protein is detected in it. In the worst case, a pregnant woman may experience cramps.
This is a very dangerous complication that requires cesarean section regardless of gestational age. Also, the detachment of the placenta 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 you have to remove the uterus.
Thyrotoxic crisis
This condition is considered the most dangerous for a woman. It develops very quickly, begins a strong tachycardia in a pregnant woman, vomiting, diarrhea and tremor.
Thyrotoxic crisis often leads to fetal death. Therefore, in order to prevent this condition, women with problems in the thyroid gland should be monitored by an endocrinologist throughout the entire period.
It is strictly forbidden to independently change the dosage or completely cancel the drug. Otherwise, detrimental consequences in the future cannot be avoided.
Thyrotoxicosis in pregnancy: effects on the fetus
This disease can sometimes affect the development of the child in utero. All changes in the maternal body, especially negative ones, are necessarily reflected in the baby. Doctors point out that improper treatment of the disease in the mother during pregnancy can give the same pathology in the child.
The fetus may linger 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 mom.
The consequence of thyrotoxicosis during pregnancy for a child can be dangerous, cause his death in the last stages of pregnancy. This is the most deplorable result when bearing a fetus for a woman.
And also in a born baby, thyrotoxicosis can be observed. It often passes on its own, as the drugs that the mother drinks are prescribed, they enter the baby through breast milk.
Malformations and Prevention
Severe forms often lead to violations in the child. He may have 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 in 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 necessarily undergo all necessary examinations before conceiving a baby, and then consult an endocrinologist and warn him about a possible pregnancy soon. He will adjust the dosage and give further recommendations.
What do you need to know?
Care must be taken 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 large malfunctions of the thyroid gland. In this case, surgery to remove the thyroid gland can not be avoided.
If during pregnancy planning problems are identified in this direction, then a woman should first undergo treatment. Then, after confirmation of remission, you need to wait another six months, and then only begin to conceive.
In this way, you can avoid the effects of drugs on the development of the future fetus. To avoid relapse, an operation to remove the thyroid gland can be performed. It is often done to women whose reproductive age is running out, and she can no longer wait.
After such an operation, a future mother is prescribed lifelong hormone therapy. She is properly selected dosage and drug. In this case, she can already become pregnant at any convenient time.
If a woman encountered such a problem during the bearing of a fetus for the first time, then after delivery it is necessary to contact an endocrinologist again and undergo an examination. Because the disease can remain and begin to develop actively.
In this condition, pregnant women are also recommended to take sedatives, which will help to cope with nervous tension, which occurs against the background of hormonal failure.
Often, by the end of pregnancy, thyrotoxicosis disappears on its own, and the symptoms disappear completely.