Pregnancy is one of the most joyful periods in the life of every woman, but not always everything proceeds as we would like. When carrying a child in a woman’s body, serious changes take place, in particular, in the thyroid gland.
In this case, the very structure of the organ and the ratio of hormones produced change. It is very important to find out whether changes in the thyroid gland and pregnancy are compatible, and how to carry and give birth to a healthy 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. Impaired functioning of this organ can have a significant effect on the rate of puberty, cause menstrual irregularities, and lead to infertility or miscarriage.
In women, thyroid pathologies are much more common than in men, so when planning a pregnancy, you must definitely make sure that there are no diseases. For this, a laboratory diagnosis is sufficient, that is, to 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, complete rehabilitation and restoration of normal hormonal balance occurs.
A woman with a removed thyroid gland needs to be on hormones all her life. In this case, pregnancy planning is required with the obligatory consultation of an endocrinologist. The doctor will observe the woman until delivery.
However, it is worth noting that in the absence of the thyroid gland, the issue of termination of pregnancy may repeatedly arise.
Thyroid condition after pregnancy
Drowsiness, psychological discomfort and weakness in a woman after delivery are attributed by many to postpartum depression. However, all these disorders can also occur due to malfunctioning of the thyroid gland. It is worth noting that often after pregnancy, the thyroid gland begins to work much more actively, and against the background of this, thyroiditis develops.
During the period of carrying the baby, the immune system weakens so that the fetus can normally consolidate. 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 to the thyroid gland, other organs also suffer.
Postpartum thyroiditis is a consequence of excessive activity of the immune system. At risk are mainly women with diabetes or already having a history of the disease. Thyroiditis can gradually turn into hyperthyroidism or hypothyroidism.
Basically, treatment of the thyroid gland after pregnancy is not required. The doctor can only prescribe beta-blockers that normalize the heartbeat. With the occurrence of hypothyroidism, thyroid drugs are prescribed, which will be safe for the newborn child.
How the thyroid gland affects pregnancy
Hormones of this organ play a very important role, as they regulate all types of metabolic processes, 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. Given a sufficient amount of hormones in the blood of a woman, the normal development of all the basic systems in a child is possible.
During pregnancy, the thyroid gland and parenchyma increase in size so that hormones are produced in much larger quantities. At about 12-17 weeks, the fetus's own thyroid gland is laid, however, 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 in the body, and the harmful effects of external factors. Among the main diseases of the thyroid gland, it is necessary to distinguish the following:
- hypothyroidism;
- hyperthyroidism;
- euthyroidism;
- chronic thyroiditis;
- malignant tumor.
Pregnancy is quite difficult during hypothyroidism of the thyroid gland, since such a pathology is characterized by insufficient iodine content in the body and subsequent hormone deficiency. Such a pathological condition sometimes occurs even before pregnancy, which is why during the planning of the conception of a child, it is necessary to undergo a full examination.
Among the main manifestations of this condition, the following should be distinguished:
- fatigue;
- loss of appetite;
- fragility of hair and nails;
- weight gain;
- dyspnea;
- swelling;
- dry skin.
If all these signs occur, the doctor should conduct an additional examination. If the diagnosis is confirmed, then you must definitely 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 the child, since such a violation significantly increases the risk of miscarriage, premature birth or fetal freezing.
A significant drop in hormone levels can lead to deafness, mental retardation, and strabismus in a newborn baby.
Thyroid diseases and pregnancy are very closely interconnected. Quite often, hyperthyroidism is observed. This condition has a physiological character, since basically the thyroid hormone is always elevated during pregnancy, so that it can make up for the fetus. However, in some cases, the doctor perceives the excessive functioning of this organ as a deviation.
The most common manifestation of hyperteriosis is nodular goiter. The disease is accompanied by the formation of large nodular formations. To avoid harmful effects on the condition of the baby, the doctor carries out the correction of hormones in the blood.
The entire period of carrying a baby takes place under the strict supervision of an endocrinologist. Basically, the operation is not performed. Intervention is indicated only if the formation squeezes the trachea, disrupting normal breathing. Among the main symptoms you need to highlight:
- sharp weight loss;
- temperature rise;
- insomnia;
- irritability;
- increase in pressure;
- muscle weakness.
The consequences of hyperthyroidism can be very dangerous late gestosis, fetal developmental abnormalities, as well as low birth weight. If the disease was detected in a timely manner, then the probability of a healthy baby being born is very high.
Euthyroidism is a borderline condition characterized by proliferation of thyroid tissue in the form of a diffuse increase in nodes in size with normal levels of thyroid hormones. Such a violation is temporary. Usually, against the background of the course of such a pathology, dangerous changes in this organ are observed.
Among the main features you need to highlight:
- neck pain;
- sleep impairment;
- psycho-emotional overstrain;
- sensation of a lump in the throat;
- an 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 of abortion. If a tumor is detected, the doctor prescribes a biopsy. 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 progressing forms of cancer require urgent surgery, regardless of gestational age.
Chronic autoimmune thyroiditis occurs as a result of the formation of antibodies to own cells. In this case, the immune system begins to gradually destroy the thyroid gland. Pathology is hereditary or is provoked by gene mutations. Such a violation adversely 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
During pregnancy, the thyroid gland has a very important functional value, and any problems with this organ negatively affect the well-being of the woman and the development of the fetus. The cause of thyroid problems during the period of bearing a child may be a sharp change in hormonal levels. This is especially acute during multiple pregnancy, as it can trigger hypothyroidism. The reason for this condition can be increased production of placental hormones, which lower the level of TSH in the blood. In addition, provocative factors include:
- frequent and indomitable vomiting;
- cystic drift;
- trophoblastic disease;
- early gestosis.
Hyperthyroidism and its symptoms can provoke the occurrence of neoplasms in the thyroid gland. They require close attention from endocrinologists, since they can degenerate into a malignant tumor.
The 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 pathology, it is necessary to highlight:
- general malaise;
- apathy;
- distraction;
- severe weakness;
- swelling of the face;
- tearfulness;
- disruption of the digestive tract;
- excessive sweating.
With a lack of hormones in the body, a woman has problems with conception. Often put a disappointing diagnosis - infertility.
Diagnostics
It is worth noting that the diagnosis of the state of the thyroid gland during pregnancy has its own specific features.
In particular, the doctor prescribes:
- tests for hormone levels;
- biopsy
- ultrasound diagnostics.
Be sure to carry out thyroid tests during pregnancy. They help determine the level of thyroid hormones and antibodies. At the same time, it is imperative to remember 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.
For the study of nodular formations, ultrasound diagnostics is performed. 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 negatively affects the condition of the fetus, regardless of gestational age.
The rate of hormones and deviations
If thyroid hormones are elevated during pregnancy, then this is considered the norm, especially in the early stages, since it is the maternal hormones that enter the fetus. Iodine demand 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 should be noted that the level of TSH does not change and should be 0.2-3.5 μMU / ml. The indicator of free T4 in the first trimester should be 10.3-24.5 nmol / L, and in the 2nd and 3rd trimester this indicator should normally be 8.2-24.7 nmol / L.
If there are deviations from these indicators, you should definitely visit an endocrinologist, who, according to the results of the study, will select the treatment methodology. It is worth noting that analyzes 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.
Treatment
If there is a deviation from the norm of the thyroid gland during pregnancy, then timely treatment is usually required. Therapy of diseases of the endocrine system has certain features, since it is important to take into account changes in the body of the expectant mother.
An elevated level of globulin in the blood makes it difficult to diagnose a hormonal level and make a diagnosis. High thyroxine results in a change in the functioning of many organs, which also needs to be taken into account when conducting therapy.
In the presence of hormonal changes in the blood, the endocrinologist may prescribe a synthetic thyroxine. In case of hyperthyroidism, “Propitsil” is prescribed. This drug is used in the presence of toxic diffuse goiter and acts on thyroid cells. It reduces the proliferation of pathological cells, and also eliminates signs such as tremors, cramps, 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.
If malignant cells are detected, surgery is often required. It is worth noting that problems with the thyroid gland can lead to various kinds of disorders and even the birth of a dead child.
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 psychoemotional state of a woman.
Among the most common complications, it is necessary to highlight:
- miscarriage;
- arterial hypertension;
- high blood pressure;
- premature birth;
- severe 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 increases the risk of fetal freezing.
After delivery, 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 have a close relationship, which is why the prevention of the occurrence of pathologies of this organ is very important. Endocrine pathologies are often found in women of reproductive age, and every year their number only grows. That is why before planning pregnancy it is recommended to conduct a comprehensive diagnosis to determine the features of the functioning of this body. This will allow you to timely determine the presence of pathology and conduct treatment.
The complex of preventive measures includes the appointment of pregnant women with iodine. You need to take them from the first weeks until the delivery. Additional intake of iodine in the body will help reduce the likelihood of goiter formation and normalize hormonal levels.
For prevention, women are recommended to consume iodized salt. The menu must also include products with a high iodine content. 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.