Starting from a Case of Hyperthyroidism during Pregnancy

Pregnant 32 weeks, ms. Liu suddenly felt abdominal pain and was sent to the hospital by her family and gave birth to a baby boy prematurely. What never occurred to me was that after the doctor’s examination, she found that ms. Zhou’s face was flushed, her heart rate accelerated, her neck was swollen, and after blood was drawn to check thyroid function, she found that ms. Zhou had [hyperthyroidism].

However, it is fortunate that mother and child are safe. Why do you say that?

Does what affect pregnant women with thyroid diseases?

If hyperthyroidism or hypothyroidism is not diagnosed and treated in time, it will cause serious negative effects on pregnant women and their fetuses. Thyroid diseases increase the risk of premature delivery, stillbirth, fetal growth and development disorders, and placental abruption.

Placental abruption refers to the placenta falling off from the inner wall of the uterus before delivery, which is a serious disease that can cause the death of the mother and fetus.

Therefore, Ms. Liu’s hyperthyroidism has not been treated, and it is fortunate that her mother and child are safe in the end.

Why is it easy for pregnant women to get thyroid diseases?

Pregnancy in October is a beautiful wait, waiting for happiness to knock at the door. But why is there hyperthyroidism?

During pregnancy, the body’s need for thyroxine increases and the basal metabolic rate increases significantly. The thyroid gland has to work overtime to expand production capacity to meet the physiological needs of the mother and the fetus. Changes in the thyroid gland and the levels of thyroid hormones it produces may induce thyroid diseases.

In addition, the demand for iodine increases during pregnancy and lactation. If iodine intake is insufficient or iodine deficiency occurs at this time, thyroid diseases are also easy to occur.

Other causes of thyroid diseases include Hashimoto’s thyroiditis, an autoimmune thyroid disease caused by abnormal attacks and destruction of thyroid cells by the immune system.

Can hyperthyroidism be prevented?

Giving birth to a healthy and intelligent baby is what every family expects, and how to give birth to a healthy and intelligent baby is also what every pregnant mother wants to know.

However, unfortunately, there is no way to prevent thyroid diseases at present. All that can be done is regular examination.

Thyroid diseases increase premature, stillbirths, Fetal growth and development disorder, And the risk of placental abruption. Therefore, screening thyroid function during pregnancy preparation can effectively prevent the occurrence of thyroid dysfunction in pregnant women. In particular, women who have had thyroid disease history, family history, or found thyroid-related antibody positive, goiter and other risk factors should check thyroid function before pregnancy.

In addition to hyperthyroidism, hypothyroidism during pregnancy is more common clinically, including:

    Clinical hypothyroidism, i.e. The level of serum thyroid stimulating hormone (TSH) increases and the level of free tetraiodothyronine (FT4) decreases; Subclinical hypothyroidism, i.e. Elevated serum TSH level and normal FT4 level; HypoT4emia, that is, serum TSH level is normal and FT4 level is reduced.

The incidence of fetal death, abortion, malformation and low birth weight of untreated clinical hypothyroidism pregnant women has increased significantly, which will also affect the development of fetal nervous system and intelligence.

Once the diagnosis of hyperthyroidism and hypothyroidism is made clear, treatment should be started immediately to reach the treatment target as soon as possible and reduce the risks of mother and fetus.

How to do if you find hyperthyroidism when you are pregnant?

Thyroid function screening during pregnancy is done in the first 8 weeks of pregnancy, preferably before pregnancy.

1. For those with obvious T4 increase accompanied by positive thyroid peroxidase antibody (TPOAb) and TSH decrease, excluding other reasons, clinical hyperthyroidism should be considered, and appropriate antithyroid drugs should be selected according to the time of pregnancy, and FT4 and TSH should be monitored every 2-6 weeks, and medication should be adjusted.

2. For mild T4 increase, TSH decrease and TPOAb negative, it may be transient hyperthyroidism in pregnancy, which can be reexamined after 4 weeks and generally does not require antithyroid drug therapy.

Will thyroid diseases be passed on to babies?

If a mother has thyroid disease, about half of her offspring may suffer from thyroid disease when they grow up. Therefore, it is very important for mothers with thyroid disease and their children to understand the symptoms and signs of thyroid disease and check the thyroid regularly.

Like Ms. Liu’s newborn, it is recommended to carry out thyroid function screening within 2-7 days, and it is recommended to track and monitor the thyroid hormone level in serum every 3-6 months. If there is any abnormal situation, you should consult an endocrinologist.