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Close Watch: Pregnancy can be smooth with thyroid disease

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Women who have thyroid disease can still have smooth pregnancies and deliver healthy babies, said Dr. Heather Mertz, who treats patients with high-risk pregnancies at Wake Forest University Baptist Medical Centre.

But they need careful monitoring and treatment to minimise the risks to themselves and their babies.”The risk is a lot less if you have good control of thyroid disease before becoming pregnant,” she said. Mertz delivered Alexander and Ashley Sullivan, who were born with congenital goitres. Their mother, Jennifer Sullivan of Glade Springs, Va., found out that she had an overactive thyroid when she was 20 weeks pregnant.Hyperthyroidism in pregnancy, in general, is not common, Mertz said. The incidence of thyroid disease in women of reproductive age is about 1 percent, she said. Complications, such as the Sullivan twins’ goitres, are far less common, said Dr. Steven Block. He is the medical director of the neonatal intensive-care unit at Brenner Children’s Hospital. Doctors think that the Sullivan twins developed goitres either from the drug her mother took to control her condition or from antibodies that her body produced in response to the disease.How a woman handles thyroid problems during pregnancy depends on what type of thyroid disease she has, Mertz said. If her thyroid is underactive, she needs to make sure that she receives enough medicine to supplement the hormones that her thyroid produces. Symptoms of an underactive thyroid include fatigue and weight gain.Some evidence shows that, without adequate treatment, women with underactive thyroids could give birth to children with developmental delays, neurological problems and low IQs, she said. Thyroid supplements are considered beneficial during pregnancy for these women.Women who have overactive thyroids also require treatment during pregnancy, Mertz said. But the medications cause more side effects. Symptoms of an overactive thyroid include nausea, weight loss, a fast heartbeat, trouble sleeping and feelings of nervousness.Women who take medication for overactive thyroids need frequent ultrasounds to check the baby’s growth and the appearance of its thyroid gland. Their babies have a higher risk of dying close to term.”We do more testing for these foetuses,” Mertz said. Doctors have to balance the risks of the medications against the risk of uncontrolled thyroid disease, which include a dangerous condition called a thyroid storm, which is caused by an extreme excess of the thyroid hormone.A thyroid storm can cause fever, a fast heart rate, dehydration, fever, high blood pressure and altered levels of consciousness. “Everything is on overdrive,” Mertz said. “It’s really scary to see patients in that condition.”If a pregnant woman goes into a thyroid storm, the chances that her baby will die are high.Some women can be treated for a short period during pregnancy, then stop taking their thyroid medication. Others can forgo medication throughout their pregnancy, but they must be closely monitored.After giving birth, some women develop hashimoto’s thyroiditis, an inflammation of the thyroid. Symptoms include depression and fatigue, and the syndrome is sometimes mistaken for postpartum depression. “Often it can be treated, and it will go away,” Mertz said.(Source: Wake Forest University Baptist Medical Centre: July 2006).


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Posted On: 26 July, 2006
Modified On: 16 January, 2014

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