Can I get pregnant with hyperthyroidism? What are the effects of pregnancy with hyperthyroidism on the fetus? Some mothers discover that they have hyperthyroidism after becoming pregnant, and other mothers have hyperthyroidism that relapses during pregnancy after being treated for hyperthyroidism before pregnancy. So can you get pregnant if you have hyperthyroidism? Can pregnant women inherit hyperthyroidism from pregnant women to their babies? What will happen if you become pregnant with hyperthyroidism? What impact will it have on the fetus? What are the precautions for pregnant women with hyperthyroidism during childbirth? The editor of Babao.com will talk about it below: Can you get pregnant with hyperthyroidism?
Effects of hyperthyroidism pregnancy on the fetus.
Can I still get pregnant if I have hyperthyroidism?
You can get pregnant even if you have hyperthyroidism. However, it is best to control the thyroid index within the normal range or to get pregnant before getting pregnant. This is good for both the pregnant woman and the fetus. If hyperthyroidism is not treated and pregnancy occurs, it may have adverse effects on pregnant women and fetuses, such as miscarriage, premature birth, gestational hypertension, heart failure, fetal growth restriction, developmental abnormalities, etc. I believe that every woman who wants a baby does not want this to happen, and hopes to have a healthy and smart baby. Therefore, if you plan to have a child, you must actively treat hyperthyroidism, take medication under the guidance of a doctor, and conduct regular check-ups. In addition, the medication for hyperthyroidism during pregnancy preparation and early pregnancy may be adjusted or replaced. Therefore, after you decide to have a child, you should inform your doctor and ask the doctor to help you formulate a treatment plan for the entire pregnancy, frequency of review, etc.
If I am pregnant, will my child inherit hyperthyroidism?
Hyperthyroidism does have a certain genetic risk. But it does not mean that if the father has hyperthyroidism, the child will definitely have hyperthyroidism. People with genetic genes for hyperthyroidism also need to be stimulated by certain environmental factors to induce the occurrence of hyperthyroidism. So there is no need to be too entangled and anxious.
The effects of pregnancy with hyperthyroidism on the fetus
1. Causes the fetus to suffer from congenital hyperthyroidism
Congenital hyperthyroidism is caused by long-acting thyrotropin substances in the mother passing through the placenta and entering the fetus. Recommendation: Women diagnosed with hyperthyroidism should first undergo treatment for hyperthyroidism and try to wait for recovery before becoming pregnant again.
2. Affect the intellectual development of the fetus
For women suffering from hyperthyroidism, constant drug treatment will inhibit the development of the fetus.Congenital hypothyroidism (creta) caused by thyroid function, affects the development of the fetal central nervous system and causes retardation in intellectual development. suggestion:
For pregnant women whose hyperthyroidism is stable, who are already pregnant, and who are not planning to undergo abortion, it is recommended to use drugs that have no risk of teratogenesis and pass through the placenta less frequently, such as PTU. It is not advisable to perform 131 iodine diagnosis and treatment. If 131 iodine treatment is used before pregnancy, contraception must be done for six months before pregnancy can occur.
3. May cause stillbirth
When suffering from hyperthyroidism, diagnosis and treatment with iodine can cause acute fetal thyroid enlargement, compress the trachea and cause asphyxia. , severe cases can lead to stillbirth. Moreover, when pregnant women with hyperthyroidism take large amounts of antithyroid drugs during pregnancy, they are prone to miscarriage, fetal dysplasia, and fetal death in utero.
Suggestions:
The impact of hyperthyroidism on pregnancy is potential. Pregnant women with hyperthyroidism are prone to premature birth. If there is a threat of premature birth, they should actively protect the fetus. Avoid using beta-receptor stimulants during treatment. Try to stay in bed as much as possible. Use magnesium sulfate, Turinal, Tocolytic drugs such as procaine.
4. Neonatal malformations
Fetal malformations often occur when the mother suffers from hyperthyroidism. In hyperthyroidism, the incidence of low-birth-weight infants and premature infants increases, and neonatal and perinatal mortality increases.
Suggestions:
Pregnant women with hyperthyroidism may easily develop pregnancy-induced hypertension in the late stages. Pay attention to early calcium supplementation and low-salt diet. Pay attention to weight changes, edema, urine protein and elevated blood pressure during prenatal check-ups. At 37 to 38 weeks in the third trimester of pregnancy, pregnant women should be admitted to the hospital for observation. Fetal heart rate monitoring should be performed every week to pay attention to fetal distress. Pregnant women should have an electrocardiogram to see if there is heart damage. If necessary, an echocardiogram should be performed.
Precautions for pregnant women with hyperthyroidism
1. B-ultrasound to observe the fetal thyroid size and whether there is goiter. If there are abnormalities, it may cause dystocia and consider cesarean section. Regarding the choice of delivery method, except for obstetric factors, vaginal delivery is generally possible and most cases go smoothly.
2. Pregnant women with hyperthyroidism generally have strong uterine contractions, small fetuses, and relatively short labor. There are reports of high neonatal asphyxia rates. During the labor process, energy should be replenished, eating should be encouraged, appropriate infusions should be provided, oxygen should be inhaled and fetal heart rate monitored throughout the process, blood pressure, pulse, and body temperature should be measured every 2 to 4 hours, and attention should be paid to psychological care during labor.
3. If the mother has cardiac insufficiency, the labor process is not progressing smoothly, the fetal position is abnormal, the fetal head is stretched upward, the fetal head cannot enter the basin, etc., the indications for cesarean section can be relaxed. Postpartum antibiotics are given to prevent infection.
4. The pediatrician should be present when the newborn is born, make preparations for newborn resuscitation, and collect umbilical cord blood to check thyroid function.
How to treat hyperthyroidism in pregnant women
1.
Try not to get pregnant before hyperthyroidism is under control, otherwise it will be detrimental to both mother and baby. Miscarriage, stillbirth, intrauterine growth retardation, premature birth, preeclampsia, and even hyperthyroidism crisis may be induced, which may threaten the patient\’s life.
2.
If a patient develops hyperthyroidism during pregnancy and chooses to continue the pregnancy, antithyroid drug treatment should be the first choice. Propylthiouracil is the drug of choice because propylthiouracil has a high binding ratio to plasma proteins and has a lower placental passage rate than methimazole (only 1/4 of methimazole).
In addition, cutaneous aplasia caused by methimazole is more common than propylthiouracil. Therefore, propylthiouracil should be the first choice for hyperthyroidism during pregnancy, and methimazole can be used as an alternative second-line drug. .
3.
When using antithyroid drugs for treatment, it is advisable to choose the smallest effective dose to maintain thyroid function at a high normal level to avoid causing maternal and fetal hypothyroidism, affecting the intellectual development of the fetus, and causing cretinism (i.e., cretinism). ).
4. If antithyroid drugs are ineffective, or the patient is allergic to antithyroid drugs, or the patient\’s thyroid is significantly enlarged and requires large doses of antithyroid drugs to control hyperthyroidism, surgical treatment may be considered.
The timing of surgery is generally chosen in the second trimester (that is, between 4 and 6 months of pregnancy), and the hyperthyroidism condition needs to be controlled before surgery. Surgery in early and late pregnancy can easily cause miscarriage.
5. 131I treatment is prohibited for pregnant and lactating women. Because fetuses are more sensitive to radiation, radionuclides can enter the fetal thyroid gland through the placenta and cause damage to the fetal thyroid gland, leading to fetal hypothyroidism. Women of childbearing age must first confirm that they are not pregnant before undergoing 131I treatment. If the patient has previously received 131 iodine treatment, contraception should be used within six months after treatment.
6. When treating hyperthyroidism in pregnant women, it is generally not advisable to add thyroxine tablets. Because levothyroxine (L-T4) can hardly pass through the placenta, it is meaningless in preventing fetal hypothyroidism. Moreover, the use of L-T4 will inevitably increase the dosage of antithyroid drugs, so it is not suitable to use L-T4 together.
7. In principle, pregnant women should not use propranolol as auxiliary treatment because it can cause spontaneous abortion, intrauterine growth retardation, neonatal bradycardia, and premature birth.
8. In order to prevent antithyroid drugs from affecting the thyroid function of infants through milk, it was generally recommended that women who need to continue taking antithyroid drugs after childbirth should adopt artificial feeding.
However, many clinical studies in recent years have shown that patients with hyperthyroidism take moderate doses (Antithyroid drugs (whether PTU or MMI) with PTU<300mg/day or MMI<2mg/day) are safe for postpartum breastfeeding and will not affect the baby\'s thyroid function, and no complications such as neutropenia and liver function damage have been found. .
However, for safety reasons, it is recommended that patients take the medicine immediately after breastfeeding, and then feed the second milk four hours later, so that the interval between breastfeeding and the last dose is at least 3 to 4 hours. At this time, the concentration of the drug in the milk will be It is already very low and has little effect on the baby.
9. The condition of pregnant women with hyperthyroidism should be controlled appropriately to prevent maternal and fetal hypothyroidism. During treatment, it is best to test thyroid function once a month, and control FT4 at the upper 1/3 of the normal value. This range is more suitable for both mother and baby. Note: It generally takes 4 weeks for FT4 to improve, and 6 to 8 weeks for TSH to improve, which is obviously behind thyroid hormone. Therefore, FT4 should be selected as an observation indicator for adjusting medication during pregnancy.
