Hypothyroidism and pregnancy: What you need to know

This article is professionally consulted by Master, Doctor Vu Thi Duyen - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Hypothyroidism during pregnancy can cause many serious complications for the baby such as stillbirth, miscarriage, fetal growth retardation. Therefore, this knowledge about hypothyroidism is very necessary and important for mothers who are about to become pregnant as well as have been pregnant.

The thyroid gland is a butterfly-shaped endocrine gland located at the front and bottom of the neck. The function of the thyroid gland is to synthesize thyroid hormone, which is then secreted into the bloodstream and transported to the tissues of the body. Thyroid hormone helps the body use energy, keep warm, and keep the brain, heart, muscles and other organs working properly.
When the level of thyroid hormone in the blood decreases, it will cause hypothyroidism, then the function of the thyroid gland will be disrupted, not synthesizing and releasing enough thyroid hormone.
Hypothyroidism during pregnancy can be caused by many causes, the most common being Hashimoto's thyroiditis, a chronic autoimmune thyroiditis, hypothyroidism after surgery to remove all or part of the gland. hypothyroidism, hypothyroidism after radiation therapy, hypothyroidism after taking antithyroid drugs, pituitary disease, goiter, iodine deficiency, family history of many thyroid diseases, people who have had thyroiditis or hypothyroidism in the past pre-pregnancy... are in the high-risk group for hypothyroidism.
Hypothyroidism in pregnancy is a common condition and can be missed if symptoms are mild. Symptoms of hypothyroidism are often mistaken for depression.
The following symptoms are usually detected in the majority of patients with hypothyroidism during pregnancy:
The face is swollen, the skin is stretched. Fatigue, slow pulse. Poor cold tolerance, poor concentration, very forgetful. Weight gain: Weight gain is detected in the majority of patients with hypothyroidism during pregnancy

Digestive disorders: Abdominal cramps or discomfort. Increase TSH concentration and decrease FT4 concentration.

2.1. Effects on the mother Being hypothyroid during pregnancy often exposes a pregnant woman to all of the classic complications of hypothyroidism such as:
Slowness, sleepiness all day is very pleasant to bed. Anemia, muscle weakness. Congestive heart failure, sluggishness, constipation... There is a risk of other obstetric-related complications such as pre-eclampsia, placental anomalies, post-partum bleeding. These complications tend to be common in women with severe hypothyroidism, and most cases of mild hypothyroidism during pregnancy may be asymptomatic or very mild and difficult to detect.
2.2. Effects on the fetus The fetal thyroid gland is only formed and begins to function at 10-12 weeks of pregnancy, this means that during the first 12 weeks, the fetus is completely dependent on thyroid hormone from the person. mom. Therefore, if the mother has hypothyroidism during pregnancy, then:
Miscarriage rate doubles, perinatal mortality rate is approximately 20%, birth defects increase 20%. The baby will also have hypothyroidism like the mother. Thyroid hormone plays a role in the brain development of children, children with congenital hypothyroidism can have severe abnormalities in both intellectual and physical development if not detected and treated. timely. The placenta is the place where nutrients are transferred from the mother to the baby, due to the abnormality of the placenta in the mother, the baby will be underweight.

3.1. Treatment of hypothyroidism in pregnancy Treatment of hypothyroidism in pregnant women is the same as for men and non-pregnant women with hypothyroidism, that is:
Use synthetic thyroid hormone instead. During pregnancy, the dose will usually have to be increased by 25-50%, sometimes doubling the dose. The optimal dose of levothyroxine must be adjusted prior to pregnancy and TSH checked as soon as possible during pregnancy so that the physician can adjust the TSH to normal. Thyroid function is checked every 6-8 weeks during pregnancy to make sure thyroid function is normal. If the dose of levothyroxine is changed, thyroid function should be checked after 4 weeks. As soon as possible postpartum, the dose of levothyroxine is returned to the same as before pregnancy. It is important to know that prenatal vitamins contain iron and calcium, which will decrease the absorption of thyroid hormone from the gastrointestinal tract. Therefore, it is necessary to take the drugs at different times, at least 2-3 hours apart.

3.2. Prevention of hypothyroidism in pregnancy To prevent hypothyroidism during pregnancy, pregnant women need a diet rich in iodine such as seafood, shrimp, crab, fish, crab..., seaweed, seaweed, vegetables. dark green like amaranth, jute, spinach...; Fresh fruit, meat and milk...
Besides, moms need to check for goiter, do blood tests for hormones FT4 and TSH, thyroid ultrasound... to detect the disease as soon as possible. .
Hypothyroidism is a dangerous disease not only for the mother but also for the fetus. Therefore, pregnant women need to have regular screening and timely treatment when they suspect that they have thyroid disease, to avoid affecting themselves and the fetus.
Specialist in Endocrinology - Diabetes, Vinmec Times City International Hospital is the address for examination and treatment of Endocrine diseases such as pituitary, thyroid, adrenal and diabetes diseases.
The specialist always works closely with the IVF Center - Obstetrics Department in the management of patients with thyroid disease during pregnancy, gestational diabetes and always applies new techniques in disease treatment such as: Research and application of stem cell technology in the treatment of diabetes; Treatment of benign thyroid nodules by radiofrequency ablation (avoiding BMN surgery for thyroid nodules).
The internal specialties of the Department of Internal Medicine have affirmed their reputation when they have spacious facilities, with clinics that meet 5-star hospital standards; modern equipment with biochemistry machines meeting ISO standards,... the most modern X-ray, ultrasound, CT scanner, MRI machines; Inpatient treatment area with 5-star standard, along with a team of specialists with many years of experience.
Master. Doctor. Vu Thi Duyen has more than 10 years of experience in general medical examination and treatment, especially has strengths in examination and treatment specialized in nephrology - Endocrinology.
The doctor has participated in many domestic and foreign seminars and is currently a Nephrologist - Endocrinology Department of General Internal Medicine, Vinmec Hai Phong International General Hospital.