Hyperthyroidism in pregnancy

This disease is diagnosed in many women during pregnancy. It causes its increased level of hCG. It is he who stimulates the thyroid gland of a person and can lead to the development of pathological processes in it. By itself, hyperthyroidism during pregnancy can occur because of the high level of hormones produced by the thyroid gland.

[1], [2], [3]

Causes of hyperthyroidism in pregnancy

Hyperthyroidism can develop in women during the period of gestation. And as statistics show, this is quite common. The main reason for the appearance of hyperthyroidism in pregnancy is an increase in the hormone of the chorionic gonadotropin. It is he who indicates the presence of pregnancy. Its main function is stimulation of the thyroid gland.

He may have another basis, which has nothing to do with conception. An easy form of the disease can develop due to the physiological condition of the woman. There is nothing dangerous in this, but at too high a level of hormone it is necessary to begin treatment.

There are other causes of the disease. These include Graves-Bazedov's disease, toxic adenoma, the presence of goiter and inflammation of the thyroid gland. There may be hyperthyroidism in the presence of severe vomiting in pregnant women, as well as with a bubble drift. These phenomena are not connected in any way with the occurred conception and development of the fetus.

[4], [5], [6], [7], [8]

Pathogenesis

The development of the disease occurs against the background of increased synthesis and secretion of thyroid hormones of the thyroid gland. This is due to increased circulation in the blood of stimulants of thyroid secretion. It is possible that the basis of pathogenesis is the release of thyroid hormones, without participation in this synthesis process. This condition can be observed with various clinical syndromes.

In fact, the pathogenesis of the disease is not fully understood. However, it is still believed that the disease is a consequence of the action of immunoglobulins. After all, they are focused on specific antigens. The disease can occur after several years, after its primary detection. And there will be no clinical manifestations in this case.

In any case, hyperthyroidism negatively affects the body of a pregnant woman. It can lead to the development of serious complications and consequences, thereby causing a serious risk to the health of the mother and child.

Symptoms of hyperthyroidism in pregnancy

When hyperthyroidism is not so easy to get pregnant, but if it does happen, then the pregnant woman may have certain clinical manifestations. So, the main symptoms of the presence of hyperthyroidism in pregnancy are severe weakness and fatigue, as well as a decrease in working capacity.

Often a woman is pestered by excessive drowsiness and forgetfulness. It is rather difficult to concentrate attention, because you always want to sleep. The victim may begin to gain weight, dry skin and hair. A woman is beset with signs of an intestinal disorder, including permanent constipation and the development of hemorrhoids. There may be violations from the central nervous system: unexplained anxiety and depression.

Most often, the disease affects people who suffer from immunodeficiency. Almost 30% of the world's population suffers from hyperthyroidism. Fix the statistics simply, enough to constantly use iodine.

First signs

With mild disease, there may be a slight increase in body weight, usually it does not exceed 5 kilograms. But this is due to a strong appetite. Often observed tachycardia, the pulse is rapid and reaches 100 beats per minute. A woman is pestered with excessive sweating, even in a cold room. Pregnant is too irritable. These are the first signs for the mildest form of the disease.

The average degree of the disease is characterized by an increase in body weight of up to 10 kilograms. Pathological changes in the myocardium are observed, the pulse is rapid and equal to 120 beats per minute. The woman is too irritable, not excluded: anxiety, sleep disturbance, increased tearfulness and excitability. If you stretch your arms forward, you can see a slight tremor.

A severe disease is characterized by a sharp weight loss. Tachycardia is stable, the pulse is 140 beats per minute. The heart rhythm is clearly impaired, heart failure is observed. Arterial pressure can greatly increase, tremor is strong and spreads to the whole body.

[9], [10], [11], [12], [13]

Effects

If hyperthyroidism does not begin to be treated on time, it can lead to serious complications. Its danger is that there is a risk of premature birth and placental abruption. One of the consequences is preeclampsia. The development of congestive heart failure is not ruled out. Finally, an increased hCG hormone and problems in the thyroid gland can provoke miscarriage. All these consequences apply to the mother. The disease can cause harm and baby.

Hyperthyroidism can develop in a child. There is a risk of premature birth, which leads to prematurity of the baby. At birth, a crumb can have very low weight and will have to stay in the hospital for a while until sufficient body weight is collected. Finally, against the background of all that is happening, hypotrophy can develop. All this shows that the disease must be diagnosed in time and treated, in order to prevent serious complications.

Complications

Hyperthyroidism can lead to miscarriage. In this case, you will have to resort to an emergency treatment of the disease or to start supporting therapy. Often, there is a risk of abortion at any time. Therefore, the girls are under the constant supervision of doctors. A serious complication is the threat of premature birth. At a period of 7 months, this is not so terrible, in other cases there is a risk that the baby simply does not survive.

Pregnant women are being harassed by a strong toxicosis, and it is almost impossible to send it off. Development of gestosis is not excluded. The baby can develop congenital malformations of the heart, brain, and genitals. This is possible if the disease is very difficult. Finally, the fetus itself can have congenital hyperthyroidism. All this entails a serious danger. Women with this disease should in no case be ignored by the advice and recommendations of doctors.

[14], [15]

Diagnosis of hyperthyroidism in pregnancy

The first step is to collect an anamnesis. Clinical manifestations of the disease are: increased heart volume, heat intolerance, the presence of mild tachycardia, and systolic murmur. These symptoms can be observed in normal pregnancy. Methods of diagnosing hyperthyroidism during pregnancy are no different from the usual study. Initially, you need to know from the patient about the symptoms that pester her.

The disease is characterized by a low level of TSH and an elevated T4 and T3 content. This can be learned through an ordinary blood test. In addition, it would be advisable to conduct a radioisotope scan. But, during pregnancy, this method is prohibited. Therefore, the diagnosis is made based on the collected anamnesis, as well as the results of physical research. In order to rule out the possibility of developing a bubble drift, resort to ultrasound. This type of study is also used for multiple pregnancies.

[16], [17], [18], [19]

Analyzes

Initially, it is necessary to visit a doctor and consult with him regarding further actions. Standard tests include blood donation. Thanks to her research, you can determine the level of TSH, as well as T4 and T3. Their increased content indicates a serious problem.

In the first trimester of pregnancy it is recommended to pass a coagulogram. Simply put, this is an analysis of blood coagulability. If the coagulable activity of the blood is increased, then the pathological process develops in the body.

In addition, it is advisable to visit the endocrinologist. To consult at least 2 times a month, it will allow to notice possible complications in the early stages. A similar requirement is made for geneticist consultations. You need to visit them throughout the first trimester. This will avoid complications that may affect the developing fetus.

[20], [21]

Instrumental diagnostics

In addition to blood tests, you should resort to a general study of the body. First of all, they resort to ECG. This method allows you to explore the heart and notice the malfunction in his work. ECG is one of the foundations of instrumental diagnostics.

One method is not enough, so they resort to ultrasound. It will allow not only to see changes in the thyroid gland of a woman, but to identify possible pathologies of development in a child. Finally, Doppler is often used. This study is aimed at the study of uterine-fetoplacental blood flow. If it is violated, it is necessary to identify the cause of such a confluence of circumstances and begin to eliminate it.

In addition to all the above studies, CTG is also used. Cardiotocogram allows you to evaluate the work of the fetal heart. All these methods are aimed at examining the woman's body and revealing pathological processes in it.

Differential diagnostics

Before resorting to the basic methods of diagnosis, the patient must be interviewed. Its appearance and manifestation of clinical symptoms play an important role. The history and consultation of doctors is the first stage of differential diagnosis. It is advisable to visit an endocrinologist, and do it at least 2 times a month. Seeking help is also worth it for genetics, you will have to go to them for consultations during the first trimester.

After this, they start laboratory methods of research. These include a common blood test and a coagulogram. The blood test allows you to determine the level of TSH, T3 and T4. If TTG is lowered, and T4 is high, then a pathological process develops in the woman's body. Finally, an important analysis is a coagulogram. You only need to spend it in the first trimester. This study allows the determination of coagulated blood activity. With hyperthyroidism, it is elevated.

[22], [23], [24], [25], [26], [27], [28]

Treatment of hyperthyroidism in pregnancy

Treatment of the disease completely depends on its stage, as well as the reasons for its origin. For this, tests are submitted, and ultrasound is performed. Usually, the treatment of hyperthyroidism during pregnancy is carried out with the help of antipsychotics, which should be taken in a small dose. Select them in such a way that the impact on the baby was minimal. And this requirement is put forward both during pregnancy and during breastfeeding.

Substances of this type are not able to penetrate the placenta and thus are completely safe. If there is no treatment, there is a risk of severe consequences. Sometimes drug therapy does not bring a positive effect, in which case they resort to surgical intervention. The operation is possible only in the second trimester.

To eliminate the disease, radioiodine is not used in any case, because it is very toxic. During the course of the disease should be observed and after childbirth. With normal control of the thyroid gland, the generic process passes smoothly, without complications.

Medications

During the treatment of hyperthyroidism, many drugs are taken. The choice depends on the condition of the woman, as well as the form of the disease. Most often resort to the use of such drugs as Propylthiouracil and carbimazole. It is often recommended to take Metimazol, Tirozol and Betaxolol.

• Propylthiouracil. The dosage of the drug is administered on an individual basis. Usually apply 0.1-0.3 grams up to 6 times a day. Self-use is not recommended. It can not be used during pregnancy, during lactation. Naturally, you can not do without this medication. Therefore, the optimal dose should appoint a doctor. The drug can lead to the development of itching, nausea and vomiting.
• Carbimazole. The dose is prescribed by the doctor, especially if the patient is pregnant. The main effect of the drug is the normalization of the thyroid gland. The agent can cause allergic reactions from the body.
• Methimazole. The agent should be applied at 0,02-0,06 grams per day. Duration of treatment can be a month and a half. Do not use the drug with hypersensitivity. Possible the development of allergic reactions and violations of the liver.
• Tyrozole. The daily dose of the drug is prescribed by the attending physician. Whichever it is, it is worth dividing it into 2-3 receptions, washing down with a copious amount of liquid. Use the drug is not necessary for hypersensitivity, cholestasis and agranulocytosis.
• Betaxolol. The agent is applied inward to 20 mg once a day. It is not recommended to reject a dose prescribed by a doctor. Use the drug is not necessary for cardiogenic shock, chronic heart failure and hypersensitivity. May cause abdominal pain, nausea and vomiting.

Alternative treatment

Alternative medicine offers a lot of effective means. And you can take them both externally and inward. As an alternative treatment, it is recommended to look at the clay. Since ancient times, it was known about its beneficial properties. To normalize the work of the thyroid gland I actively use a compress based on this ingredient. Prepare it simply, you need to dilute the clay with water to the consistency of sour cream and apply to the fabric, and then to the neck for one hour. Throughout the day, you can repeat the procedure 2-3 times. The effect is really stunning, and most importantly, safe.

Widely used and herbs. The following collection has proved to be very good: mocrica, valerian and chicory. Chicory is able to normalize the functioning of the thyroid gland and thereby reduce the amount of hormones it produces. Infusion is simple, you need to take all the ingredients, mix with each other. Then take 2 teaspoons of the collection, and pour two glasses of water. After that the agent is boiled for 3 minutes, cooled and used for 2 days in equal quantities.

[29], [30], [31], [32]

Herbal Treatment

Pay attention to the grass, they have a mass of useful properties and are able to quickly cure a person. Use herbal treatment carefully, especially during pregnancy.

• Herbal collection number 1. It is necessary to take the root of the cotton napkin, the herb of the cat, oregano and minerals. Add the bouquet with leaves of peppermint and grasshopper leaves. All ingredients must be taken in equal quantities. After that, everything is mixed and taken only 2 tablespoons of the collection. They need to pour 500 ml of boiling water and put in a thermos all night. Take half a glass 3 times a day before meals. The duration of therapy is 2 months. If necessary, the course can be repeated after 12 weeks.
• Herbal collection number 2. It is necessary to take the herb grass with rhizome, flowers of black head, leaves of thyme, and also flowers of hawthorn. As additional ingredients are: thallus kelp, valerian root and cones of hops. All this is taken in the same quantity and is prepared according to the collection No. 1.
• Herbal collection number 3. It is necessary to acquire the root of the bedstraw, the flowers of arnica and the fruits of capers. As auxiliary components are: grass leaves motherwort, cat, strings, knotweed and melissae. All the ingredients should be mixed together and take only 2 tablespoons of the collection. Cook and take everything according to collection number 1.

Homeopathy

The effectiveness of taking homeopathic remedies depends entirely on the individual characteristics of the organism. A major role in this is played by the disease itself, as well as its course. Therefore, homeopathy should be used exclusively under the supervision of an experienced specialist.

Hyperthyroidism is characterized by an increase in the functionality of the thyroid gland. This process is accompanied by a decrease or increase in body weight, as well as rapid heart rate and increased nervousness. The disease strongly affects the cardiovascular, nervous and endocrine systems. He must be treated without fail. Homeopathic remedies are selected taking into account individual characteristics of a person and are calculated only on a specific person.

The treatment is completely safe and effective. Its action is aimed at normalizing the thyroid gland. In some severe cases, homeopathic drugs are used together with hormones. For such a state, the selection of drugs by the ART method is typical. It informatively shows the deviations in the work of the organ and allows you to select quality treatment.

Operative treatment

Earlier, surgical intervention during pregnancy was widely used. To date, it is recommended to be carried out only in extreme cases. So, operative treatment is provided for persons suffering from allergic reactions, with intolerance to antithyroid drugs. People with too much goiter also come here, as well as if there is a suspicion of thyroid cancer.

Surgical intervention is necessary if too high doses of drugs are required, as well as the occurrence of serious adverse reactions from the body. Finally, this method of treatment is used when a woman does not comply with the prescribed regimen, as well as increased resistance to antithyroid drugs. The question of surgical intervention is raised in the case when the use of medicines does not allow controlling the course of the disease. It is worth noting that the operation is capable of leading to spontaneous abortion and premature birth. Therefore, surgery should be done only in the second trimester. The risk of complications at this stage is not so high.

Prevention

Preventive measures include additional use of iodine. It is advisable to bring the daily dose to 200 mg. This will avoid the development of the disease. To select the preparations rich on the maintenance of iodine the attending physician should. In this case, you need to take into account the climate, the patient's condition, and the reasons for which hyperthyroidism has arisen. Some experts recommend the use of food supplements as a preventive measure. In fact, this should not be done. There is no exact data on the use of iodine in any products. You can use iodized salt.

Preventive measures should include the implementation of antenatal and postnatal prevention of iodine deficiency in the body. It is advisable to start taking special medications six months before the planned pregnancy. This type of prevention excludes the development of pathological processes, but not in all cases. The risk of developing hyperthyroidism still persists. Therefore, future mothers should carefully monitor their own health and, when strange symptoms appear, seek help from a doctor.

Forecast

Even timely treatment of the disease can not give accurate data on the further state of a person. In this case, to predict what the forecast will be practically impossible. It is clear one thing, the faster a person turned for help, the higher the chance for a successful recovery.

Neither medication nor surgical treatment can exactly tell what the prognosis will be. Therefore, it is necessary to listen to the doctor's recommendations and not to ignore them. In this case, the prognosis is much better.

If you do not start treatment on time, you may develop serious consequences. These include premature birth, and even termination of pregnancy. All this is very dangerous. In this case, the forecast will be extremely unfavorable. The further condition of the patient depends entirely on her. Preventive measures and quality treatment will not allow the situation, worsen and provoke unpleasant consequences.

[33], [34], [35], [36]

ICD-10 code

Each disease is marked by its unique code. The international classification of diseases makes it easier to work physicians around the world. After all, now each disease has its own universal code for microbial 10, regardless of the city and country.

So, hyperthyroidism in another way is called thyrotoxicosis. He was given his own unique code - E05. This subgroup includes - thyrotoxicosis with diffuse goiter numbered E05.0, thyrotoxicosis with toxic single-node goiter - E05.1, thyrotoxicosis with toxic multinodular goiter - E05.2, thyrotoxicosis with ectopia of thyroid tissue - E05.3. The following are also referred to here: thyrotoxicosis artificial - E05.4, Thyroid crisis or coma - E05.5, Other forms of thyrotoxicosis - E05.6 and thyrotoxicosis, unspecified - E05.7.

All these diseases are characterized by their manifestations, as well as by symptoms. Diagnosis is the same, but the treatment varies depending on the complexity of the situation, as well as the age of the person.