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Hypothyroidism in pregnancy: Treatment, symptoms, advice and help

About hypothyroidism in pregnancy

Hypothyroidism is an endocrinal condition in which there is diminished secretion of the thyroid hormone by the thyroid gland. The thyroid gland is located in the neck just below the voice box and secretes the thyroid hormone which is responsible for maintaining the metabolism of the body. Pregnancy is sometimes a triggering factor in development of hypothyroidism.

Hypothyroidism in pregnancy: Incidence, age and sex

Hypothyroidism in pregnancy is not an uncommon occurrence. It may be concurrent with pregnancy or develop for the first time during pregnancy or it may also develop after delivery. In fact a woman has 4 times higher risk of developing hypothyroidism after delivery if she has a history of diabetes mellitus.

Signs and symptoms of hypothyroidism in pregnancy: Diagnosis

Hypothyroidism in pregnancy manifests as vague and non-specific symptoms like brittle nails, dryness of hair and skin, intolerance to cold, constipation, persistent exhaustion and lethargy. Psychological symptoms like irritability and depression are also commonly seen in affected individuals.

A detailed history and physical examination, including palpation of the thyroid gland leads to suspicion of diagnosis. The suspicion is confirmed by a blood test which assesses the levels of thyroid stimulating hormone (TSH) and thyroxine (T4).

Causes and prevention of hypothyroidism in pregnancy

Hypothyroidism may develop during pregnancy or after delivery. This is seen due to inflammatory reaction in the thyroid after delivery. The exact cause of such a phenomenon is not clear. It is essential to conduct blood tests for hypothyroidism in women in the reproductive age group so that she can be timely and adequately managed.

Hypothyroidism in pregnancy: Complications

Hypothyroidism in pregnancy is a significant condition which requires extensive monitoring and management. If it is not treated adequately, it may lead to several complications affecting both mother and the baby. The affected woman may stand at an increased risk of miscarriage or still births and also increase in blood pressure in last trimester of pregnancy. There are increased chances of premature delivery. Moreover the baby born to a woman with unmanaged hypothyroidism may exhibit significant developmental delay in milestones along with stunted physical and mental growth and other birth defects.

Hypothyroidism in pregnancy: Treatment

The goal of treatment of hypothyroidism in pregnancy is the same as in hypothyroidism in non-pregnant state i.e. to replace the deficient thyroid hormone. However, it is important to maintain level of thyroid hormone in blood at a high normal range. Levothyroxine is the most common agent used. Periodic monitoring of the blood levels of the thyroid hormone is needed to assess and adjust the dosage. It is also advisable to increase the amount of iodine in the diet which is found in milk and seafood.