THYROID IN PREGNANCY

The thyroid is a butterfly-shaped gland situated in the front of the neck near the voice box or Adam’s apple. It releases a hormone which is responsible for the regulation of metabolism.

Sometimes it may release hormones in excess or in fewer amounts which creates the problem accordingly.

It plays a crucial role in maintaining the development of a healthy baby and the health of the expecting mother.

Role of Thyroid in Baby

The thyroid hormone helps in the normal development of the fetus’s brain and nervous system.

For the first 3 months, the fetus is dependent on the mother’s supply for the thyroid hormone, which comes through the placenta.

At around 12 weeks, the fetus’s thyroid gland starts functioning on its own.

So it is difficult to diagnose Thyroid problems in pregnancy because of high levels of thyroid hormone as the symptoms are common to both pregnancy and thyroid disorders.

Physiologically

Occasionally, during 1st half of pregnant women may suffer from hyperemesis gravidarum; severe nausea and vomiting which is due to high levels of HCG hormone produced by the placenta. This HCG may cause a temporary increase in the thyroid hormone as it mimics TSH i.e. thyroid-stimulating hormone which stimulates the thyroid to produce more hormone.

In the 2nd half of pregnancy; when the HCG levels are down, the thyroid levels again come to normal.

The other female hormone oestrogen which increases during pregnancy produces high levels of thyroid-binding globulin, it is a protein that transports thyroid hormone in the blood which can also count on to the increased level of thyroid in pregnancy.

Thus, the gland produces more hormones as a result, thyroid enlarges slightly in expecting healthy women.

This distinctly enlarged thyroid can be a sign of thyroid disease and should be discussed with the healthcare person immediately.

Pathologically

In Women

Perceptible Increased or decreased thyroid hormone in blood during pregnancy can lead to many problems like miscarriage, premature birth, low birth weight, heart failure in the fetus, etc.

It can happen with the women suffering from autoimmune diseases like Grave’s disease-causing rise in thyroid level or Hashimoto’s disease-causing descent in thyroid level.

In Baby

If the hormone level is high in the baby then it can lead to rapid heart rate; early closure of the soft spot in the skull; poor weight gain; irritability; and sometimes distended thyroid may compress against the windpipe and interfere with breathing causing dyspnoea

Diagnosis

It can be monitored by undergoing a simple blood test:

TSH test
T3 and T4 test
TSI test

In mild increase or decrease in thyroid hormones; i.e during 1st trimester, generally the treatment is not required.

But if there is a perceptible increase in the levels then the women should consult the gynecologist and should start the medication under supervision.

Things to Follow by Expecting Mother With Thyroid Problem

The women who have thyroid issues can easily undergo a healthy pregnancy and protect their baby’s’ health by learning about the effect of thyroid on pregnancy and keeping it in check by taking the right measures.

Monitoring the thyroid level in blood and taking the medicine required under the guidance of health care provider
Visiting for a prenatal check-up as guided by the gynecologist
Maintaining a balanced and healthy diet.
Prenatal multivitamin and mineral supplement containing iodine to be given under doctor’s guidance.
Keeping an eye on weight gain; required during pregnancy.
Being happy, calm and optimistic is a key to sound pregnancy!!

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