Treatment of hyperthyroidism in pregnant women

The article was professionally consulted with Associate Professor, Doctor, Doctor Hoang Dang Mich - Head of Department of Medical Examination & Internal Medicine - Department of Medical Examination and Internal Medicine - Vinmec Ha Long International Hospital.

Hyperthyroidism during pregnancy is an obsession for many women of reproductive age. The treatment of hyperthyroidism is also challenging when it requires close guidance from the doctor and effort on the part of the patient.

Hyperthyroidism is a condition of increased thyroid function due to excessive secretion of T3, T4 manifested by signs and symptoms of thyrotoxicosis.

Because it occurs mainly in women of reproductive age, the rate of women with hyperthyroidism during pregnancy is very high. When you have hyperthyroidism, the concentration of thyroxine hormone in the mother's blood is very high, causing typical symptoms such as trembling hands, fast heartbeat, rapid pulse, bulging eyes, even heart failure. Thyroxin entering the fetus at high concentrations can also lead to increased fetal heart rate, smaller fetuses for age, and may cause birth defects and malformations. In some cases it even leads to premature birth, miscarriage or stillbirth.
Therefore, doctors advise women with hyperthyroidism not to get pregnant, especially when the disease is in an advanced stage, it is best to treat hyperthyroidism thoroughly before becoming pregnant.

The treatment of hyperthyroidism relies on oral medications, collectively known as synthetic antithyroid drugs (KGTH). These drugs have been used quite a lot and are evaluated to be effective, significantly improving the condition of hyperthyroidism. However, like other drugs, most synthetic antithyroid drugs such as methylthiouracil (MTU), methimazol, thyrozol, carbimazol, propylthiouracil (PTU) are dangerously toxic and cause fetal hypothyroidism.

Therefore, the use of drugs during pregnancy must be very careful, correct indications and minimum doses. Avoid letting hyperthyroidism turn into drug-induced hypothyroidism because these two states cause a lot of harm to the fetus.

If thyroid gland is not properly treated, it will endanger the health of both mother and baby. However, there is no indication for abortion if hyperthyroidism is present. Women with hyperthyroidism who become pregnant do not necessarily need to terminate the pregnancy.
Among the synthetic antithyroid drugs, PTU is assessed to be less permeable to the fetus and safer than other types. The use of this medicine still requires the supervision of a specialist. If medical treatment is not possible, surgical treatment can be done through goiter surgery. However, this method is rarely applied because the surgery is related to anesthesia, which is not beneficial to the fetus. Also should not be treated with iodine - radioactive, because iodine - radioactivity can enter the fetus, destroy the fetal thyroid gland, causing permanent hypothyroidism for the child.
The most reluctant case needs to terminate the pregnancy, it is also necessary to treat hyperthyroidism until the disease is temporarily stable to terminate the pregnancy. Because sudden abortion can cause acute hyperthyroidism (thyroid storm) endangering the life of the pregnant woman. In addition, when hyperthyroidism, pregnant women can use beta-blockers to reduce symptoms of hand tremors, palpitations. However, this supplement should only be used when clearly needed and in limited amounts because it can affect the development of the fetus (born with low birth weight).
People with hyperthyroidism but get pregnant, if they know how to treat it well, most of the babies will still be born normally. During the third trimester of pregnancy, hyperthyroidism may subside, but after delivery, it becomes more severe. At that time, we can treat hyperthyroidism like non-pregnant people (with conventional antithyroid drugs).

Thus, women with hyperthyroidism during pregnancy can still give birth normally as long as they know they are pregnant at the right time. When you get pregnant at the wrong time, you need to keep a calm attitude to protect the pregnancy (according to the doctor's instructions).
The fetal stage is very important to the formation of the child, and is also influenced by the mother's health and mental health. In addition to taking medicine and regular follow-up check-ups, the mother needs to pay attention to the lifestyle, rest, eating, limiting stress, anxiety...
Having hyperthyroidism during pregnancy will definitely making pregnancy more difficult, but with the right treatment measures and the mother's efforts and support from relatives, the birthing journey will arrive safely, the result "mother will be round, baby will be born. square".

Hyperthyroidism in pregnant women can bring a lot of worries and concerns to the patient and family. In this case, the patient can go to the Department of Endocrinology - Vinmec Times City International Hospital to be examined and receive the best advice in diagnosing and treating the disease.
Vinmec Times City is currently the destination of endocrinology examination chosen by many customers because of the gathering of a team of highly qualified, experienced and dedicated doctors and nurses for the health of the patients. In addition, the hospital also owns comfortable facilities, a system of modern machinery and equipment to help best support the diagnosis and treatment of diseases.
Associate Professor. Dr. Hoang Dang Mich has over 42 years of medical practice, has strengths in the specialized fields of Liver - Kidney - Immune pathology... Currently, he is a Specialist Consultant in General Internal Medicine Department of Examination. Medicine & Internal Medicine, Vinmec Ha Long International General Hospital.