Hyperthyroidism in pregnancy is a change in the thyroid gland that leads to increased production of the hormones T3 and T4, resulting in symptoms such as accelerated or irregular heartbeat, tremors in the hands or weight loss for no apparent reason.
Hyperthyroidism can appear before or during pregnancy, and is usually caused by Graves’ disease, and when left untreated can cause problems such as premature birth, hypertension, placental abruption and miscarriage.
This disease can be detected by an obstetrician or endocrinologist through a blood test, and its treatment involves the use of medications that regulate the functioning of the thyroid. After giving birth, it is necessary to continue medical monitoring, as it is common for the disease to remain throughout the woman’s life.
Symptoms of Hyperthyroidism in Pregnancy
The main symptoms of hyperthyroidism in pregnancy are:
- Excessive sweating;
- Heat intolerance;
- Tremor in the hands;
- Tiredness or insomnia;
- Shortness of breathe;
- Anxiety or nervousness;
- Fast or irregular heartbeat;
- Severe nausea and vomiting;
- Accelerated bowel movements;
- Weight loss for no apparent reason or inability to gain weight, despite eating well.
The symptoms of hyperthyroidism in pregnancy can often be confused with symptoms that arise due to hormonal changes common during pregnancy.
Therefore, it is important to have prenatal care or consult an obstetrician when symptoms of hyperthyroidism appear, so that the most appropriate treatment can be diagnosed and initiated to avoid complications.
Make an appointment with an obstetrician in the nearest region:
Taking care of your health has never been easier!
How to confirm the diagnosis
The diagnosis of hyperthyroidism in pregnancy is made by the obstetrician, using the same blood tests as for non-pregnant women, such as measuring T3, T4 and TSH in the blood.
Normally during pregnancy, the TSH hormone is lower and T4 may be elevated, due to thyroid stimulation by beta-HCG.
Therefore, diagnosing hyperthyroidism during pregnancy can be difficult due to the normal hormonal variations at this stage.
Therefore, the doctor may order an anti-TSH receptor antibody (TRAb) test to help diagnose Graves’ disease, which is one of the causes of hyperthyroidism in pregnancy, and rule out other conditions with similar symptoms, such as transient gestational thyrotoxicosis. .
Possible causes
Hyperthyroidism in pregnancy is mainly caused by Graves’ disease, which is an autoimmune disease in which the body produces anti-thyrotropin TSH receptor antibodies (TRAb), which bind to the thyroid, stimulating the production of hormones, resulting in symptoms.
Graves’ disease can appear during pregnancy or before pregnancy. For women who already had Graves’ disease before pregnancy, symptoms can usually improve in the second or third trimester. See more about Graves’ disease.
How the treatment is carried out
The treatment of hyperthyroidism during pregnancy must be carried out under the guidance of an obstetrician or endocrinologist, and the medication propylthiouracil may be indicated in the first trimester of pregnancy, and methimazole, from the second trimester of pregnancy, as they help regulate the production of hormones by the thyroid. .
At first, larger doses are given to control hormones more quickly, and after 6 to 8 weeks of treatment, if the woman shows improvement, the dose of the medication is reduced and may even be suspended after 32 or 34 weeks of pregnancy.
It is important that the treatment is carried out according to medical advice, otherwise high levels of thyroid hormones can lead to the development of complications for both the mother and the baby.
Possible complications
Complications of hyperthyroidism during pregnancy can affect both mother and baby, the main ones being:
1. Complications for women
The main complications of hyperthyroidism during pregnancy for women are:
- Miscarriage;
- Part premature;
- Gestational hypertension or pre-eclampsia;
- Premature placental displacement;
- Cardiac insufficiency.
These complications are related to the lack of treatment or incomplete treatment of hyperthyroidism during pregnancy.
2. Complications for the baby
Complications of hyperthyroidism in pregnancy that can affect the baby are:
- Thyroid problems;
- Low weight at birth;
- Prematurity;
- Heart failure or tachycardia;
- Goiter;
- Fetal hydropsia.
Furthermore, other complications for the baby include uterine growth restriction and changes in the development of the nervous system, for example.
Postpartum care
After giving birth, it is necessary to continue taking medication to control the thyroid, but if the medication is suspended, new blood tests should be carried out to assess hormones 6 weeks after giving birth, as it is common for the problem to reappear.
Furthermore, during the breastfeeding period, it is recommended that medications be taken in the lowest possible doses, preferably immediately after the baby is fed and in accordance with medical advice.
It is also important to remember that children should undergo routine tests to assess thyroid function, as they are more likely to have hyper or hypothyroidism.
