Thyroid dysfunction in pregnant women

The article was professionally consulted by Specialist Doctor II Bui Thi Thu and Specialist Doctor II Tran Thi Mai Huong - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

In pregnant women, about 3-4% have thyroid dysfunction. Thyroid dysfunction in pregnant women can cause dangerous complications for both mother and baby if not treated promptly.

The thyroid gland is an important endocrine gland that regulates the body's metabolism. Thyroid dysfunction is a disease related to the thyroid gland, including:
Hypothyroidism: a condition in which the thyroid gland does not produce enough thyroid hormone. Hypothyroidism can originate in the thyroid, pituitary, or hypothalamus. Hyperthyroidism: is a condition that produces too much thyroid hormone, this syndrome is less common than hypothyroidism Goiter: not a specific disease. A goiter can be related to hypothyroidism, hyperthyroidism, or even abnormal thyroid function. Thyroid nodules: are abnormal growths or masses located inside the thyroid gland. Thyroid nodules can be caused by thyroid cysts, benign goiters, or thyroid cancer. Thyroid cancer is more common in adult women than in men or young people. There are different types of thyroid cancer, depending on the specific type of cells inside the thyroid gland. Most cases of thyroid cancer have a good prognosis and high survival rates, especially those patients who are diagnosed at an early stage. During pregnancy, the thyroid gland increases its intake of iodine to ensure normal levels of thyroid hormone production. Therefore, if the daily diet of pregnant women lacks iodine, the thyroid gland can be enlarged. Thyroid dysfunction in pregnant women is mainly hypothyroidism.

The main cause of thyroid dysfunction during pregnancy is chronic autoimmune thyroiditis, also known as Hashimoto's disease. There are cases where it is possible to have Hashimoto's disease before or during the first pregnancy.

In addition, other causes of thyroid dysfunction include:
Because the mother has had her thyroid removed. Radioiodine treatment Because the patient is being treated with Graves with too high doses of synthetic antithyroid drugs. Toxic multinodular goiter Thyroid nodules overproduce thyroid hormone Consuming excessive amounts of iodine. Pregnant women with a strong family history of thyroid disease, those who have had thyroiditis, had an enlarged goiter or hypothyroidism in a previous pregnancy, and also those who live in areas where there is a deficiency. iodine needs to be tracked and probed.

During the first 13 weeks of pregnancy, the fetus does not have a thyroid gland, so it is completely dependent on the amount of thyroid hormone provided by the mother through the placenta. This stage is the period of formation and division of fetal organs, so if there is a lack of hormones during this time, complications are very serious.
Thyroid dysfunction in pregnant women is mainly hypothyroidism. Consequences of hypothyroidism in the mother are hypertension, premature delivery, placental abruption, even miscarriage, stillbirth. For the fetus, when born, the child is dull, mentally retarded.

Hyperthyroidism in pregnant women is less common, about 1.7% of pregnant women have this disease. Consequences of hyperthyroidism cause complications such as low birth weight, miscarriage, pre-eclampsia, premature birth... Even acute hyperthyroidism during labor causes death for both mother and child with a high rate of death. up to 100%.
Screening for the timely detection and treatment of thyroid diseases in pregnant women is very important. In addition to preventing complications and reducing mortality in both mother and child, it ensures that the baby is born with a healthy body and good intellect... The earlier the treatment, the lower the risk. The lower the chance of complications in both mother and baby will be.

Pregnant women are at high risk of thyroid diseases and have been diagnosed with thyroid diseases before such as: hypothyroidism, hyperthyroidism, basedow, simple goiter, thyroid nodule...
Having a family history of thyroid disease Women who have had thyroid disease in previous pregnancies Women with poor obstetrics such as miscarriage, stillbirth, premature birth, birth defects... Women with type 1 diabetes Women with autoimmune diseases such as lupus, rheumatoid arthritis ... Women being treated for hypothyroidism Women with a history of thyroidectomy, radiation treatment of the same neck, The doctor recommends that pregnant women with the above-mentioned high-risk factors need to perform screening tests for gestational thyroid disease, which are TSH and FT4 tests to evaluate thyroid function and during pregnancy. pregnancy, should be monitored regularly.

Thyroid dysfunction in pregnant women, if not detected and timely intervention, the disease can leave dangerous complications. Therefore, pregnant women, especially those at high risk, should undergo clinical screening for goiter, blood tests for the hormones FT4 and TSH. For suspected cases, the doctor may order more thyroid ultrasound and some special blood tests. Pregnant women with a well-diagnosed thyroid dysfunction will receive timely intervention and treatment.
The 12-week Maternity Care program at Vinmec includes screening tests for thyroid disease and follow-up care if problems are found. Doctors will have a treatment plan to keep the thyroid hormone levels in balance and stabilize the health of both mother and baby during pregnancy.
It is very good to diagnose and screen for thyroid disease in pregnant women at the earliest during pregnancy and should be done early. Ideally, before planning a pregnancy, women need to have a screening test for thyroid disease to make sure it is in normal condition to ensure the best health for both mother and fetus. When knowing the status and possible risk of thyroid disease, pregnant women need to follow the treatment prescribed by a specialist.