Hypothyroidism, or an under-active thyroid if you prefer, complicates the course of a pregnancy in many ways.
Hypothyroidism is responsible for causing miscarriages in many women, especially if it goes undetected.
Other than miscarriage, hypothyroidism also increases the risk of:
- still birth
- postpartum hemorrhage
- low birth weight
- maternal anemia
Physicians have also shown there are links between hypothyroidism and developmental delays in children born of mothers with under-active thyroids.
Despite the many dangers posed by an under-active thyroid, a lot of mothers-to-be remain unaware of the facts and tell-tale signs, which means many women and their unborn babies are at great risk, and unknowingly so. This is not a predicament suffered by pregnant women only. Information and awareness on hypothyroidism, and thyroid disease in general, remains largely unexplored by the general population. In a press release issued by the American Association of Clinical Endocrinologists, 1 in 10 Americans suffered from thyroid disease, with a staggering 13 million remaining undiagnosed.
As an expecting mother, the surest way to be safe when it comes to hypothyroidism is to get thyroid testing before conception and during the first trimester. In the early stages of a pregnancy, the fetus depends on the mother to get their supply of thyroid hormones which are essential for brain development. This usually goes on up until the 12th week when the baby’s thyroid gland finally starts to function. This means that the first trimester is crucial as far as hypothyroidism treatment is concerned. It should not be interpreted to mean that hypothyroidism in subsequent trimesters should be ignored (as it impairs intellectual development in children as well), only that by this time the unborn baby will have started making use of their own thyroid gland.
Treatment of hypothyroidism in pregnant women is done using a synthetic form of T4 to replace the missing hormone. The dose must be regularly adjusted to ensure a steady blood level of the thyroid hormone is maintained, as anything outside of the normal range would be detrimental.
While hypothyroidism makes a pregnancy high-risk, it must be remembered that it is a disease that can be controlled and kept in check, allowing mother and baby to flourish to term without fatal consequences. However, this can only be done if the mother remains vigilant, and vigilance in this case means that:
- All women thinking of getting pregnant must be tested for thyroid disease.
- All expectant mothers with a goiter/enlarged thyroid or a family history of thyroid disease must be checked for hypothyroidism.
- Women who are borderline hypothyroid (that is, have low normal range hypothyroidism but do not qualify to be classified as truly hypothyroid as far as the laboratory range is concerned) should consider low dose thyroid hormone therapy soon after conception.
- If you are on thyroid hormone replacement before pregnancy, you must insist on testing to ensure your levels are appropriate for a pregnancy.
- Dosing is dynamic during pregnancy and a keen eye must be kept on your blood levels to ensure the dose you are getting is the right one. As you advance in your pregnancy, you may realize that you require higher doses.
Hypothyroidism and pregnancy are the two words that no pregnant woman wants to hear mentioned in the same sentence. However, with the right amount of information, awareness and sufficient medical care, hypothyroidism during pregnancy need not mean inevitable doom.