Pregnancy and Thyroid Diseases

By | 15 April 2021

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Pregnancy and Thyroid Diseases

Thyroid diseases are the second most important endocrine disorder affecting pregnant women after diabetes.

Physiological changes seen during pregnancy can also mimic thyroid diseases. Pregnancy, clinical disease
It may cause changes in your condition, and it may also affect pregnancy thyroid function tests.

Is There Any Importance of Dietary Iodine Taken During Pregnancy?

Dietary iodine taken during pregnancy is necessary to maintain normal thyroid activities.
changes that cause permanent thyroid stimulation and eventually the development of goiter occur in a woman with
income. When iodine supplementation in the range of 200 to 300 mcg per day (WHO recommendation) is mentioned, this
Most of the changes are corrected.

There is no certainty that hypothyroxinemia due to severe iodine deficiency has harmful effects on the fetus.
evidence is available. Goiter formation, mental retardation, neurological abnormalities may occur in the fetus.
(cretinism). Therefore, iodine deficiency should be prevented.

Pregnancy and Hypothyroidism:

It is seen in 0.1-2.5% of pregnancies. Symptoms of hypothyroidism mostly occur during pregnancy.
Constipation, hoarseness, hair loss, brittle nails,
Dryness and goiter can be seen on the skin.

Hypothyroidism during pregnancy:

Pronounced hypothyroidism or; may present as subclinical hypothyroidism.

• Subclinical hypothyroidism: It is a condition in which TSH value is high and free thyroid hormones are normal.
• However, in cases where TSH is> 10 mIU / L, even if the fT4 is within the normal range,
It is accepted as.

What Are The Complications That May Occur In Pregnant Women Who Have Been Diagnosed With Hypothyroidism?

  • Preeclampsia and gestational hypertension
  • Placental complications
  • Fetal cardiac complications
  • Delivery <32 weeks ago (very preterm birth) and preterm birth
  • Low birth weight
  • •Increased cesarean frequency
    Increased perinatal morbidity and mortality
    Neuropsychiatric and cognitive dysfunctions

Pregnancy and Hyperthyroidism:

Its incidence is 0.05-0.2% and the reasons are;

  • Graves’ Disease (85-90)
  • Toxic multinodular goiter
  • Toxic adenoma
  • Thyroiditis
  • Transient subclinical hyperthyroidism
  • Hyperemesis gravidarum

Trophoblastic hyperthyroidism (Mole hydatidiform and Choriocarcinoma). Various pregnant women
Although there may be hyperthyroidism for reasons, Graves’ disease is the most common cause.

What are the complications that can be seen in pregnant women with hyperthyroidism?

  • Stillbirth – miscarriage
  • Premature birth
  • Low birth weight
  • Pre-eclampsia
  • Heart failure
  • Thyroid storm

What are the Findings that Can Be Seen in Pregnant Women with a Diagnosis of Hyperthyroidism?

• Nervousness
• Trembling

Palpitations
Increased sweating

• Hot intolerance
Weight loss or inability to gain
Insomnia

• Increase in the number of defecations
Goiter

Which pregnant women are recommended for routine screening?

Any history of thyroid disease
• Family history of thyroid disease
Laboratory findings suggestive of goiter or hypo-hyperthyroidism on examination
• Presence of autoimmune disease
A history of miscarriage or premature birth
• Routine screening is recommended for pregnant women with a history of radiation exposure.

Pregnancy and Thyroid Cancer

The most common thyroid cancer among young women is papillary cancer, in 10% of these cancers
At the time of diagnosis, patients are in the pregnancy or postpartum period. Incidence of papillary thyroid cancer
Although the frequency is high among pregnant women, the first diagnosis is usually in the postpartum period.
are placed. Management of diagnosis and treatment of thyroid cancer during pregnancy is serious for both the patient and the fetus.
It poses a problem to contain dangers. The thyroid gland in the early stages of pregnancy is usually more
The ability to secrete excess hormones not only in terms of hormone secretion but also during pregnancy.
maybe responsible for the increased rate of differentiated thyroid cancer. Treatment of thyroid cancer in this process,
It includes surgical treatment, the use of levotrixin, and follow-up until delivery.

If a malignant thyroid nodule is detected in the first or early second trimester of pregnancy,
surgery is not terminated but is recommended in the second trimester. Papillary thyroid cancer thought to have a good prognosis
or when a follicular neoplasm is detected, the postpartum period can wait for surgery.