Definition

The thyroid is a butterfly-shaped gland in the front of the neck. Pregnancy hormones can cause changes to thyroid hormone levels. This can raise the risk of pregnancy problems when it is not treated. There are two types of problems:

The Thyroid Gland
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Causes

Hypothyroidism

Hypothyroidism in pregnancy can also be caused by:

  • Hashimoto disease, the most common cause
  • Not enough treatment for pre-existing hypothyroidism
  • Over treating hyperthyroidism

Hyperthyroidism

Graves disease is overactivity of the thyroid. It is the most common cause. Very high levels of human chorionic gonadotropin (hCG) is another cause. This may get better on its own.

Risk Factors

You may be at risk of this problem if you have:

  • A personal or family history of a thyroid problem
  • Been treated for a thyroid problem
  • A goiter
  • Hyperemesis gravidarum , a severe form of morning sickness
  • A personal or family history of immune problems

Symptoms

Symptoms of hypothyroidism are:

Symptoms of hyperthyroidism are:

  • Losing weight without trying
  • Fast or abnormal heart rhythm
  • Sweating
  • Nervousness
  • Shaking
  • Bulging eyes
  • Diarrhea
  • Problems sleeping

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done.

Your doctor will test your thryoid hormone levels. Other blood tests may also be done. Pictures of your thyroid may need to be taken. You may need to see a doctor who treats hormone problems.

Treatment

Hypothyroidism

Medicine can replace the hormone.

Hyperthyroidism

Mild hyperthyroidism will be watched closely. Some women may need to take medicine. Pregnancy hormones can cause changes in thyroid hormone levels. Your medicine needs may change during pregnancy. Your doctor will check your thyroid hormone levels every 6 to 8 weeks during pregnancy and 4 weeks after a change in dose.

If medicine does not work, the thyroid gland may need to be removed. Radioiodine is used to destroy the thyroid gland. It is rarely done during pregnancy because of the risk to the fetus.

Prevention

There is no way to prevent thyroid problems in pregnancy.

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