Thyroid hormones can also be affected due to several important physiological and hormonal changes during pregnancy. Obstetrician and Gynecologist Asst. Prof. Dr. Melis Koçer Yazıcı said that especially those with underlying thyroid disease or a family history of thyroid disease should consult a physician as soon as possible when planning pregnancy and/or finding out that they are pregnant.

Diseases that may occur due to the thyroid gland working more or less are of special importance for the pregnancy period. It requires close monitoring in terms of both the mother's and the baby's health. Yeditepe University Hospitals Gynecology and Obstetrics Specialist Assoc. Dr. Melis Koçer Yazıcı stated that women who have been treated for thyroid disease before, women with goiter disease, or women with a baby with thyroid disease should be more careful. Melis Koçer Yazıcı also added the following: “In addition, those with an autoimmune disorder, those with a family history of autoimmune thyroid diseases such as Graves' disease or Hashimoto's, women with Type 1 diabetes, those receiving high-dose neck radiation or hyperthyroidism treatment are at a higher risk for thyroid disease during pregnancy than other women. In this case, when planning pregnancy and/ or finding out that she is pregnant, she should consult a physician for the necessary examinations as soon as possible."

If Your Thyroid is Overactive...

Reminding that symptoms of hypothyroidism may occur during pregnancy due to insufficient treatment of a woman known to have hypothyroidism or excessive treatment of a woman with hyperthyroidism with anti-thyroid drugs, Asst. Prof. Dr. Koçer Yazıcı: "About 2.5 percent of women have a mild TSH value above 6 mIU/L, and 0.4 percent have an increase above 10 mIU/L." Indicating that the risk of miscarriage may increase in untreated or inadequately treated hypothyroidism, Asst. Prof. Dr. Koçer Yazıcı: “Maternal anemia, myopathy (muscle pain, weakness), congestive heart failure, preeclampsia, placental abnormalities, and postpartum bleeding are also among the possible risks.”

Thyroid Hormone Affects Baby's Development 

Underlining that thyroid hormone is critical for brain development in the baby, Asst. Prof. Dr. Melis Koçer Yazıcı gave the following information on the subject:

“Congenital hypothyroidism can cause serious cognitive and developmental abnormalities in the child if it is not noticed and treated immediately. With early treatment, these developmental abnormalities can be largely prevented. Severe untreated hypothyroidism in the mother can lead to impaired brain development in the baby. Unfortunately, there is still no consensus on screening for hypothyroidism in all women during pregnancy. Women with known hypothyroidism should have a TSH test when pregnancy is detected and should be in constant contact with their physicians.”

Inadequate Treatment Can Lead To Miscarriage!

In general, Graves' disease, the most common cause of hyperthyroidism in women of reproductive age, is a problem seen in about 0.2 percent of pregnant women. Asst. Prof. Dr. Melis Koçer Yazıcı said, "Apart from this, very high hCG levels due to pregnancy may cause ''temporary hyperthyroidism'' in early pregnancy. The correct diagnosis can be made by history, physical examination, and laboratory tests. ” Reminding that serious complications known as preterm birth and preeclampsia can be observed more frequently in pregnant women with hyperthyroidism receiving inadequate treatment, Asst. Prof. Dr. Yazıcı stated the following: "Graves' disease can occur in the first trimester, as well as symptoms and clinical exacerbation in a woman known to have a thyroid gland disorder. At this point, the right treatment is extremely important. In the case of inadequate treatment, in addition to the risk of premature birth and preeclampsia, women with active Graves' disease during pregnancy are at a higher risk of experiencing very severe symptoms of hyperthyroidism, known as thyroid storming. Graves' disease usually heals in the third trimester of pregnancy and may worsen in the postpartum period. That is why it is so important for women with Graves' disease to give their doctors detailed information about their medical history.”

Complaints Can Be Confused With Pregnancy Symptoms

Stating that those with rapid and irregular heartbeat, trembling hands, inability to gain enough weight or weight loss should inform their doctors by suspecting hyperthyroidism, Asst. Prof. Dr. Melis Koçer Yazıcı gave the following information about hypothyroidism, another thyroid problem: “Symptoms of hypothyroidism are generally the same for women with hypothyroidism and pregnant women. Excessive fatigue, problems coping with a cold, muscle cramps, severe constipation, and problems with memory or concentration can be among these symptoms. They are also very confused with the symptoms of pregnancy.”

Treatment Must Be Personalized

Underlining that women who know that they have hypothyroidism should ideally consult their doctors to regulate the doses of drugs they use before pregnancy, that is, in the precognitive period, Yeditepe University Hospitals Obstetrics and Gynecology Specialist Asst. Prof. Dr. Melis Koçer Yazıcı concluded her words as follows:

“The drug requirements used often increase during pregnancy, by an average of 25-50 percent. Thyroid function tests should be checked approximately every 4 weeks during the first trimester of pregnancy to ensure that the woman has normal thyroid function throughout the pregnancy. Immediately after birth, the doses of the drug used under the control of the physician should be rearranged. It is also important to know that prenatal vitamins contain iron and calcium, which can disrupt the absorption of thyroid hormone from the gastrointestinal tract. In women with a history of Graves' disease and treated with radioactive iodine (Rai) or surgical thyroidectomy, a risk assessment should be performed by testing Graves' antibodies (TRAb) at an early stage of pregnancy. If antibodies are high, follow-up testing is recommended at 18-22 weeks, and if antibodies are still high, additional follow-up is recommended at 30-34 weeks to assess the need for fetal and neonatal monitoring. In mild hyperthyroidism, as long as both mother and baby are in good condition, they are usually closely monitored without treatment. Thyroid surgery is rarely necessary. If necessary, it should ideally be done during the second trimester of pregnancy. Radioactive iodine therapy should not be used during pregnancy.”

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