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Thyroid and pregnancy

, medical expert
Last reviewed: 19.10.2021
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Thyroid gland and pregnancy require special attention. Since this internal organ is susceptible to various diseases. Let's consider, features of a status of a thyroid gland during pregnancy, possible diseases and other pathologies shchitovidki.

The thyroid gland (glandula thyroidea) is an internal organ that is in the front of the neck and looks like a bow or butterfly. The weight of the thyroid gland in an adult does not exceed 20 grams, but, in spite of this, it produces vital hormones that affect the metabolic process, physical condition and even mental development. As for the hormones produced by the thyroid, it is thyroxine (T4) and triiodothyronine (T3).

Thyroid and pregnancy

Iodine is a special microelement that is responsible for the normal functioning of the thyroid gland during the period of gestation. It allows glandula thyroidea to synthesize the above hormones in the required amount, and also promotes the exchange of vitamins, proteins, fats and minerals. These hormones are very important for the full intrauterine development of the reproductive system, cardiovascular and nervous systems and the musculoskeletal system. Diseases of the thyroid gland in pregnant women occupy one of the first places among the pathological processes in the endocrine system. All this suggests that during pregnancy it is extremely important to monitor the condition of the thyroid gland and regularly check the level of hormones produced by it.

The thyroid gland during pregnancy works much more intensively, therefore requires special attention. Because of this, in many women during pregnancy the thyroid gland slightly increases in size. By the way, very long ago, increased glandula thyroidea was considered the most accurate sign of pregnancy.

As for the future baby, his thyroid gland begins to form on the 5th-6th week of bearing a child, and at 12-13 weeks already accumulates iodine and independently produces hormones necessary for the development of the growing body. All this suggests that the task of a pregnant woman to ensure the supply of iodine in the body, as it is important for both the future child and herself. In the first months of pregnancy, the development of the embryo depends on the normal functioning of the maternal glandula thyroidea. And even after the thyroid gland in the embryo has formed, the iodine that enters the mother's body ensures its normal functioning.

During gestation, the daily dose of iodine for a woman is about 200 μg. If a woman lacks iodine in the body, it can provoke pathologies in the development of the child and thyroid disease in the pregnant woman. Treatment of thyroid gland during pregnancy is carried out sparing methods, but with some diseases, the issue of abortion becomes acute.

Thyroid gland in pregnancy planning

The thyroid gland is very important when planning a pregnancy. It is from the condition of glandula thyroidea and the hormones it produces that the success of conception and pregnancy depends. The physical development of the future baby and the level of intelligence depend on the quality of thyroid hormones produced. That is why, during the period of pregnancy planning, the first task of a woman is to pass tests to determine the hormone level of the thyroid gland and to perform an ultrasound examination in order to determine whether the organ functions normally.

When planning pregnancy, special attention is paid to the level of thyroid-stimulating hormone, which should not exceed 2.5 μIU / ml. If the tests showed that the level of the hormone is above the specified value of the norm, then this is an occasion to turn to the endocrinologist. The doctor will prescribe a therapy to normalize the level of the hormone. Very often as a treatment prescribed diet with foods with high iodine content. After the results of tests for the hormones glandula thyroidea will be normal, you can plan pregnancy.

Thyroid gland diseases and pregnancy

Thyroid disease and pregnancy are interrelated. Diseases appear due to hormonal changes in the body and the negative impact of the environment. Let's consider the main diseases of the thyroid gland during pregnancy.

  • Pathology at birth is an underdeveloped thyroid, lack of thyroid gland, wrong location.
  • Goiter (endemic, sporadic) - occurs due to lack of iodine in the body or negative influence of the environment. The disease is also related to these diseases.
  • Thyroiditis is an inflammatory disease of the glandula thyroidea.
  • Hypothyroidism is a disease that is accompanied by a decrease in thyroid function.
  • Damage and tumors of the thyroid gland.

If a woman is absolutely healthy, then during pregnancy, thyroid disease does not affect her. The only thing that expects is an increase in thyroid gland, but it is considered normal, therefore should not cause concern. But, despite this, it is better to once again make sure that glandula thyroidea is healthy and does not threaten anything.

Enlarged thyroid gland in pregnancy

An enlarged thyroid gland during pregnancy is considered normal. Shchitovidka increases in size due to hormonal changes in the body and with increased work. But do not forget that the increase in this body can be associated with a number of diseases. This is true for women who before the carrying of the child had diseases of glandula thyroidea. Let's look at the pathologies that arise during pregnancy and cause an increase in the thyroid gland.

  • Hypothyroidism - occurs due to a violation of the body's immune system and is considered a chronic disease. It is difficult to diagnose this illness during child-bearing. Since the symptoms of the disease largely coincide with the signs of pregnancy. Therefore, if you suspect a disease, you need to take a blood test and judge by its results about the level of hormones glandula thyroidea.
  • Thyrotoxicosis - a disease that occurs due to increased activity of the thyroid gland and is accompanied by an increase in this body. In pregnant women, this disease is extremely rare. The main symptom of the disease is severe vomiting and an increase in eyeballs. To accurately diagnose a disease, it is necessary to pass tests for thyroid hormones. If a woman becomes pregnant, and she already had this disease, then there is a high risk for the child and the normal course of pregnancy.

The enlarged thyroid gland during pregnancy can change under the influence of hormones or because of a certain disease. That is why, during pregnancy planning, a woman should undergo a diagnosis of glandula thyroidea, and if necessary, treatment.

trusted-source[1], [2], [3], [4]

Thyroid enlargement in pregnancy

An increase in the thyroid gland during pregnancy is a completely normal process that occurs under the influence of hormones and increased thyroid function. But the increase can be caused by diseases. Let's look at the extent of the enlargement of the thyroid gland that a woman can expect during the period of gestation. 

  • The thyroid gland looks quite normal, slightly enlarged, but does not cause discomfort or painful symptoms.
  • The contours of the neck are changed, when swallowing, the thyroid glans are clearly visible.
  • The enlarged thyroid gland is visible to the naked eye, the neck has become thicker, it is painful to swallow, there is shortness of breath.
  • Glandula thyroidea is greatly enlarged, the contours of the neck are changed and the thyroid glands are traced on its surface. It hurts to swallow, it suffers a feeling of perspiration in the throat and cough.
  • At the last stage, the thyroid gland is so enlarged that it makes it impossible to swallow and breathe. Also, the voice can change or disappear.

Each of the above-described stages of thyroid enlargement during pregnancy should be examined by an endocrinologist for the presence of diseases.

Thyroid cancer and pregnancy

Thyroid cancer and pregnancy in recent times increasingly sounds like a sentence. But do not go to extremes, because with the correct approach to diagnosis of cancer and treatment, you can endure and give birth to a healthy baby. The risk of thyroid cancer in pregnancy is that in the initial stages the disease is almost asymptomatic, and the symptoms that are manifested are similar to the symptoms of pregnancy at an early stage.

To diagnose thyroid cancer in pregnancy, use ultrasound, a blood test for the detection of cancer cells and an aspiration biopsy, with which you can establish the presence of cysts or cancerous nodules in the glandula thyroidea. Please note that hormonal changes in pregnancy do not stimulate the development of cancer, and differentiated cancers do not adversely affect the period of gestation.

Pregnancy after thyroid cancer

Pregnancy after thyroid cancer is possible only after successful treatment of the disease. Modern methods of cancer treatment of the endocrine system allow women to become pregnant even if glandula thyroidea is removed. Pregnancy can be planned only a year or two after cancer treatment and after undergoing rehabilitation. Successful pregnancy is guaranteed in the absence of relapse of the disease.

If in the first months of bearing a child the disease begins to recur, the woman should terminate the pregnancy. Exceptions are women who have been treated with thyroidectomy. If, after the cancer, a long-awaited pregnancy has come, and the disease does not recur, the woman should still take tests for cancer cells on a regular basis and conduct an ultrasound examination of the thyroid gland.

Cyst of the thyroid gland and pregnancy

The thyroid cyst and pregnancy are interrelated, since the appearance of a cyst can provoke hormonal changes that occur in the female body. A cyst of the thyroid gland during pregnancy can also appear due to a lack of iodine. And this is not surprising, since during the gestation of a child the female body lacks vitamins, minerals and the substances necessary for the normal functioning of the female body and the development of the child.

Another reason for the appearance of cysts is trauma and inflammation (thyroiditis). But sometimes even nervous experiences and overstrain can cause the appearance of a cyst. Diagnose the cyst of the thyroid gland is difficult, because the cyst is small and develops almost asymptomatically. The cyst begins to manifest itself only with the increase and squeezing of neighboring organs. A woman can feel perspiration, shortness of breath and cough, and sometimes difficulty in swallowing. One of the complications that accompanies the cyst of the thyroid gland in pregnancy is the suppuration that results from weakened immunity.

trusted-source[5], [6], [7], [8], [9], [10], [11], [12]

Goiter of the thyroid gland in pregnancy

The thyroid gland during pregnancy is another common disease that occurs in many women. The main symptom of goitre glandula thyroidea is its enlargement and thickening of the neck. Goiter is a collective concept, which is understood as a thyroid disease, the main symptom of which is its increase. During the carrying of a child, goiter may appear due to disorders on the hormonal background and diseases that affect the endocrine system.

There are several types of goiter that arise during the bearing of a child, let's consider them:

  • Zob with eufunction - during pregnancy is extremely rare. As a rule, this disease is diagnosed in the early stages of endemic goiter.
  • The goitre with hypofunction is due to the deficiency of iodine in the body and the autoimmune diseases of the thyroid gland.
  • Goiter with hyperfunctions - occurs with an adenoma of the thyroid gland or Basedov's disease.

Absence of the thyroid gland and pregnancy

Absence of a thyroid gland and pregnancy, quite comparable concepts. If a woman underwent removal of the thyroid gland due to cancer and another disease, then it is possible to plan pregnancy not earlier than a year after the course of rehabilitation and absence of relapses of the disease. If all the above conditions are met, then pregnancy is possible provided that the level of thyroid hormones in the blood is regularly monitored. This will allow timely response to their increase and other pathological processes.

Note that the acute shortage of thyroid hormones when it is removed negatively affects the bearing of the baby. That is why, during pregnancy, a woman should use hormonal drugs that will make up for the lack of hormones produced by glandula thyroidea.

trusted-source[13], [14], [15], [16], [17], [18], [19], [20], [21], [22]

Thyroid gland nodes and pregnancy

Thyroid nodules and pregnancy can be diagnosed during ultrasound. As a rule, the thyroid gland nodes appear before the child is born, but are diagnosed only with the appearance of early signs of pregnancy (toxicosis, vomiting, nausea, dizziness, and others). The nodes of the thyroid can be benign and malignant. Good-quality education does not affect the course of pregnancy and child development, and malignancies require compulsory treatment.

But do not worry, since the appearance of the glandula nodes of thyroidea is never an occasion for abortion. The only thing that a woman expects is regular monitoring of the condition of the nodes, taking tests and taking safe medications that will not allow the nodes to progress during pregnancy.

Thyroid adenoma and pregnancy

Thyroid adenoma and pregnancy are completely compatible. Adenoma is a benign tumor that appears in the tissues of the thyroid. The disease is accompanied by increased production of thyroid hormones. This blocks the normal operation of glandula thyroidea. The main symptoms of the disease: increased sweating, fatigue at physical exertion, a sharp change of mood, nausea. As you can see, the symptoms coincide with the early signs of pregnancy. This is what complicates the diagnosis of adenoma.

Thyroid adenoma is not a fatal disease and does not affect the course of pregnancy. Very rarely, adenoma develops into a malignant tumor and gives metastasis throughout the body. If a pregnant woman was diagnosed with an adenoma, then during all nine months the woman should be observed at the endocrinologist.

Hyperplasia of the thyroid gland in pregnancy

Hyperplasia of the thyroid gland during pregnancy is accompanied by an increase in thyroid gland. The disease occurs because of problems with hormones, which is very important for the period of pregnancy. The main symptoms of the disease: shortness of breath, the appearance of a vascular network around the neck, problems with swallowing food. If you find these symptoms, you need to contact the endocrinologist.

For diagnosis of hyperplasia in pregnant women an ultrasound is performed, which helps to identify the disease. For the treatment of this pathology during pregnancy, women are prescribed drugs with a high iodine content. As the prevention of the disease is recommended taking iodized salt with food.

Hypoplasia of the thyroid gland and pregnancy

Hypoplasia of the thyroid gland and pregnancy are rare, usually in 2% of pregnant women. The disease is congenital, and is an underdevelopment of the tissues of glandula thyroidea. All this leads to a shortage of hormones that depress the nervous system and brain activity. Very often, the cause of this disease is the lack of iodine in the body.

I diagnose the disease with the help of ultrasound and visual examination (the thyroid gland is slightly enlarged). With regard to treatment, during pregnancy, women are prescribed drugs with a high iodine content. This allows the pregnancy to develop normally and does not adversely affect the development of the child.

Thyroid hypothyroidism and pregnancy

Thyroid hypothyroidism and pregnancy are not uncommon in our time. The disease provokes a shortage of iodine in the body. Therefore, during pregnancy, a woman must pass a blood test to the level of hormones glandula thyroidea. If the tests show that a woman has reduced thyroid function, then as a treatment hormone replacement therapy is used. The main causes of the disease are related to the level of hormones and inflammation of the thyroid gland.

Treatment of hypothyroidism of the thyroid gland during pregnancy is extremely important, as the disease can cause interruption of pregnancy due to medical conditions, fetal death in the womb or the birth of a child with serious pathologies. In women who during pregnancy were ill with hypothyroidism and did not treat it, babies with visual impairments, lesions of the brain and nervous system or deaf-mute are born.

Autoimmune thyroiditis and pregnancy

Autoimmune thyroiditis and pregnancy are interrelated, as the disease appears due to hormonal changes in the body. The disease arises from the inability of immunity to recognize painful and healthy cells. Because of this, the thyroid gland is affected by autoimmune action, which can negatively affect the period of pregnancy and development of the baby.

The main symptoms of autoimmune thyroiditis are similar to early signs of pregnancy. First of all, it is nausea, irritability, dizziness, as well as an increase in the volume of glandula thyroidea, that is, the appearance of goiter. As a treatment, therapeutic therapy is used, which is based on the intake of drugs with a high iodine content to maintain the hormones at a normal level.

trusted-source[23], [24], [25], [26], [27], [28], [29], [30]

Thyroid hormones during pregnancy

Hormones of the thyroid gland during pregnancy perform one of the most important functions - they contribute to the normal development of the brain in the child. The lowered level of hormones leads to pathological processes during pregnancy and various lesions of the nervous system and brain activity of the child. Let's consider the peculiarities of the functioning of glandula thyroidea and the development of its hormones during the period of gestation.

  • When pregnancy, the thyroid gland works twice as hard and produces 50% more thyroid hormones.
  • Normal hormones during pregnancy are no different from those of non-pregnant women.
  • In pregnancy, the thyroid gland increases by 15% and there is a high risk of hypothyroidism.

The effect of the thyroid gland on pregnancy

The effect of the thyroid gland on pregnancy is based on the production of hormones and their effect on the course of pregnancy and the development of the child. The production of hormones is regulated by the central nervous system, the pituitary gland and the hypothalamus. That is, with their lesions, there may be problems with the production of hormones glandula thyroidea and the appearance of various diseases.

To determine the disease, diagnose with ultrasound and take a blood test for hormones. Based on the diagnostic results, the endocrinologist and gynecologist make decisions regarding treatment (for hormonal disorders) or for the prevention of the thyroid gland and its effect on pregnancy.

Ultrasound of the thyroid gland in pregnancy

Ultrasound of the thyroid gland during pregnancy is a mandatory procedure for every woman. Using ultrasound, you can find out about the presence of certain diseases that will adversely affect both the health of the mother during pregnancy and the development of the child. Ultrasound refers to non-invasive diagnostic methods, because during the study, the pregnant woman is not subjected to surgical or any other treatment. Using ultrasound, you get a photograph that shows the structure of the thyroid gland, which means that you can see tumors and other painful processes.

The procedure does not require special preparation. The only thing necessary for normal ultrasound is full access to the neck. That's why a woman should be in clothes that do not cover the neck and preferably without ornaments. Ultrasound of the thyroid gland during pregnancy is carried out in the first trimester and with the appearance of a certain symptomatology.

Thyroid removal in pregnancy

Removal of the thyroid gland during pregnancy is not carried out, since the procedure may adversely affect pregnancy. If a woman has a disease that requires immediate removal of the thyroid gland for medical reasons, pregnancy must be interrupted. Because of the sudden hormonal leaps, the normal course of pregnancy and development of the child is threatened.

That is why, during the gestation period, all diseases of glandula thyroidea are treated with the safest drugs for the future mother and her baby. If a woman becomes pregnant immediately after removal of the thyroid gland, then most likely it is waiting for miscarriage due to hormone therapy, which must be passed as concluding the stage of treatment.

Pregnancy after removal of the thyroid gland

Pregnancy after removal of the thyroid gland is possible, but not earlier than two years after the operation. Such a period will allow to conduct a full-fledged rehabilitation course and restore the hormonal background of a woman. After removal of the thyroid gland, a woman will have to adhere to hormone replacement therapy all her life, and even during pregnancy. Therefore, when planning pregnancy, a woman should seek advice from a gynecologist-endocrinologist, who will observe her during the entire period of bearing.

Pregnancy after removal of the thyroid gland, as a rule, proceeds without complications, with the condition that the woman fully adheres to medical recommendations for maintaining a normal hormonal background. Hormones of glandula thyroidea are extremely important for the normal development of the child, so the expectant mother should be ready for the extremely difficult period of pregnancy.

Treatment of the thyroid gland in pregnancy

Treatment of the thyroid gland during pregnancy involves the use of conservative methods. Therapy is aimed at eliminating painful symptoms and alleviating the pathological condition. During pregnancy, as a treatment, a woman will receive hormone therapy and taking medications with a high iodine content, which will allow the future child to develop normally.

Treatment of thyroid gland during pregnancy depends on the severity of the disease and its effect on the process of bearing a child. If a woman has a benign tumor, then I use iodine therapy as a treatment. As for cancers detected during pregnancy, hormonal changes and pregnancy itself do not affect the development of the disease. In any case, the treatment and control of the disease is handled by a gynecologist-endocrinologist, who appoints a thyroid gland for a woman.

Thyroid gland and pregnancy are interrelated. So, with the normal functioning of glandula thyroidea, pregnancy proceeds without complications. If a woman has failures and irregularities in the work of this body, then medical care is required, since this can negatively affect a child's development.

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