Hyperthyroidism in pregnancy

This disease is diagnosed in many women during pregnancy. It is caused by an increased level of hCG. It is what stimulates the human thyroid gland and can lead to the development of pathological processes in it. Hyperthyroidism itself during pregnancy can occur due to the high level of hormones produced by the thyroid gland.

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Causes of hyperthyroidism during pregnancy

Hyperthyroidism can develop in women during pregnancy. Moreover, as statistics show, this occurs quite often. The main reason for the appearance of hyperthyroidism during pregnancy is an increase in the hormone chorionic gonadotropin. It is this hormone that indicates pregnancy. Its main function is to stimulate the thyroid gland.

It may also have another reason that is not related to conception. A mild form of the disease may develop due to the physiological state of the woman. There is nothing dangerous about it, but if the hormone level is too high, treatment must be started.

There are other causes of the disease. These include Graves-Basedow disease, toxic adenoma, goiter and inflammation of the thyroid gland. Hyperthyroidism can occur due to severe vomiting in pregnant women, as well as with a hydatidiform mole. These phenomena are in no way related to the conception and development of the fetus.

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Pathogenesis

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

In fact, the pathogenesis of the disease is not completely clear. 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 several years after its initial detection. Moreover, there will be no clinical manifestations in this case.

In any case, hyperthyroidism has a negative effect on 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 during pregnancy

It is not so easy to get pregnant with hyperthyroidism, but if it does happen, the pregnant woman may experience certain clinical manifestations. Thus, the main symptoms of hyperthyroidism during pregnancy are severe weakness and fatigue, as well as decreased performance.

Often, a woman is bothered by excessive sleepiness and forgetfulness. It is quite difficult to concentrate, because you constantly want to sleep. The victim may begin to gain weight, dry skin and hair are observed. The woman is bothered by signs of intestinal disorder, including constant constipation and the development of hemorrhoids. Disorders of the central nervous system may be observed: unexplained anxiety and depression.

Most often, the disease affects people suffering from immunodeficiency. Almost 30% of the entire population of the planet suffers from hyperthyroidism. It is easy to correct the statistics, it is enough to constantly consume iodine.

First signs

In mild cases of the disease, a slight increase in body weight may be observed, usually it does not exceed 5 kilograms. But this happens due to a strong appetite. Tachycardia is often observed, the pulse is rapid and reaches 100 beats per minute. The woman is bothered by excessive sweating, even in a cold room. The pregnant woman is too irritable. These are the first signs for the mildest form of the disease.

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

Severe stages of the disease are characterized by sudden weight loss. Tachycardia is stable, the pulse is 140 beats per minute. The heart rhythm is clearly disturbed, heart failure is observed. Blood pressure can increase significantly, tremor is strong and spreads to the whole body.

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Consequences

If hyperthyroidism is not treated in time, it can lead to the development of serious complications. Its danger lies in the risk of premature birth and placental abruption. One of the consequences is preeclampsia. The development of congestive heart failure is not excluded. Finally, elevated hCG hormone and problems with the thyroid gland can provoke a miscarriage. All these consequences apply to the mother. The disease can also harm the baby.

Hyperthyroidism can develop in a child. There is a risk of premature birth, which entails prematurity of the baby. At birth, the baby may have a very low weight and will have to stay in the hospital for some time until sufficient body weight is gained. Finally, against the background of all that is happening, hypotrophy can develop. All this indicates 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 emergency treatment of the disease or start maintenance therapy. Often, the risk of termination of pregnancy remains at any stage. Therefore, girls are under constant supervision of doctors. A serious complication is the threat of premature birth. At 7 months, this is not so scary, in other cases there is a risk that the baby simply will not survive.

The pregnant woman is plagued by severe toxicosis, and it is almost impossible to relieve it. The development of gestosis is not excluded. The baby may develop congenital heart defects, brain defects, and also genital defects. This is possible if the disease is very severe. Finally, the fetus itself may have congenital hyperthyroidism. All this entails serious danger. Women with this disease should never ignore the advice and recommendations of doctors.

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Diagnosis of hyperthyroidism during pregnancy

The first step is to collect anamnesis. Clinical manifestations of the disease are: increased heart volume, heat intolerance, mild tachycardia, and systolic murmur. These symptoms can also be observed during normal pregnancy. The methods for diagnosing hyperthyroidism during pregnancy are no different from the usual examination. Initially, you need to ask the patient about the symptoms that bother her.

The disease is characterized by a low level of TSH and an increased content of T4 and T3. This can be found out through a regular blood test. In addition, it would be advisable to conduct a radioisotope scan. However, this method is prohibited during pregnancy. Therefore, they try to make a diagnosis based on the collected anamnesis, as well as the results of a physical examination. In order to exclude the possibility of developing a hydatidiform mole, they resort to ultrasound. This type of examination is also used in multiple pregnancies.

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Tests

Initially, you need to visit a doctor and consult him regarding further actions. Standard tests include blood tests. Thanks to its study, you can determine the level of TSH, as well as T4 and T3. Increased levels of them indicate a serious problem.

In the first trimester of pregnancy, it is recommended to take a coagulogram. Simply put, this is a blood clotting test. If the clotting activity of the blood is increased, it means that a pathological process is developing in the body.

In addition, it is advisable to visit an endocrinologist. He should conduct consultations at least 2 times a month, this will allow you to notice possible complications at early stages. A similar requirement applies to consultations with a geneticist. You need to visit them throughout the first trimester. This will help avoid complications that may affect the developing fetus.

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Instrumental diagnostics

In addition to blood tests, a general examination of the body should be performed. The first thing to do is to use an ECG. This method allows you to examine the heart and notice any problems in its functioning. 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 woman's thyroid gland, but also to determine possible developmental pathologies in the child. Finally, Doppler is used quite often. This study is aimed at studying the uterine-fetal-placental blood flow. If it is disturbed, it is necessary to identify the cause of such a combination of circumstances and begin to eliminate it.

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

Differential diagnostics

Before resorting to the main diagnostic methods, the patient must be interviewed. Her appearance and manifestation of clinical symptoms play an important role. Collection of anamnesis and consultation with doctors is the first stage of differential diagnostics. It is advisable to visit an endocrinologist, and this should be done at least 2 times a month. It is also worth seeking help from a geneticist; you will have to go to them for consultations throughout the first trimester.

After this, laboratory research methods are used. These include a general blood test and a coagulogram. A blood test allows you to determine the level of TSH, T3 and T4. If TSH is low and T4 is high, it means that a pathological process is developing in the woman's body. Finally, an important test is a coagulogram. It should only be carried out in the first trimester. This study allows you to determine the coagulation activity of the blood. With hyperthyroidism, it is increased.

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Treatment of hyperthyroidism during pregnancy

Treatment of the disease depends entirely on its stage and the reason for its occurrence. For this, tests are taken and an ultrasound is performed. Usually, hyperthyroidism during pregnancy is treated with antithyroid drugs, which should be taken in small doses. They should be selected in such a way that the impact on the baby is minimal. Moreover, this requirement is put forward both during pregnancy and during breastfeeding.

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

Radioiodine should never be used to eliminate the disease, as it is very toxic. The course of the disease should also be monitored after childbirth. With normal control of the thyroid gland, the birth process proceeds calmly, without complications.

Medicines

During the treatment of hyperthyroidism, many drugs are taken. They should be selected depending on the woman's condition, as well as the form of the disease. Most often, they resort to using such drugs as Propylthiouracil and Carbimazole. Methimazole, Tyrozol and Betaxolol are often recommended.

• Propylthiouracil. The dosage of the drug is prescribed individually. Usually 0.1-0.3 grams are used up to 6 times a day. It is not recommended to use the drug on your own. It cannot be used during pregnancy or breastfeeding. Naturally, it is impossible to do without this medication. Therefore, the optimal dose should be prescribed by 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 to normalize the thyroid gland. The drug can cause allergic reactions in the body.
• Methimazole. The drug should be used at 0.02-0.06 grams per day. The duration of treatment can be one and a half months. The drug should not be used in case of hypersensitivity. Allergic reactions and liver dysfunction are possible.
• Thyrozol. The daily dose of the drug is prescribed by the attending physician. Whatever it is, it should be divided into 2-3 doses, washed down with plenty of liquid. The drug should not be used in case of hypersensitivity, cholestasis and agranulocytosis.
• Betaxolol. The drug is taken orally at 20 mg once a day. It is not recommended to deviate from the dose prescribed by the doctor. The drug should not be used in case of cardiogenic shock, chronic heart failure and hypersensitivity. May cause abdominal pain, nausea and vomiting.

Folk remedies

Traditional medicine offers a lot of effective remedies. Moreover, they can be taken both externally and internally. As a traditional treatment, it is recommended to take a closer look at clay. Its beneficial properties have been known since ancient times. To normalize the thyroid gland, I actively use a compress based on this ingredient. It is easy to prepare, you need to dilute the clay with water to the consistency of sour cream and apply it to the cloth, and then to the neck for one hour. You can repeat the procedure 2-3 times throughout the day. The effect is truly amazing, and most importantly, safe.

Herbs are also widely used. The following mixture has proven itself to be excellent: wood sorrel, valerian and chicory. Chicory is able to normalize the thyroid gland and thereby reduce the amount of hormones it produces. The infusion is made simply, you need to take all the ingredients and mix them together. Then take 2 teaspoons of the mixture and pour in two glasses of water. After that, the product is boiled for 3 minutes, cooled and used for 2 days in equal quantities.

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Herbal treatment

It is worth paying attention to herbs, they have a lot of useful properties and can quickly cure a person. It is necessary to use herbal treatment carefully, especially during pregnancy.

• Herbal collection #1. Take the root of cinquefoil, catnip, oregano and lemon balm. Add peppermint leaves and motherwort to the bouquet. All ingredients should be taken in equal quantities. After that, mix everything and take only 2 tablespoons of the collection. Pour 500 ml of boiling water over them and leave in a thermos overnight. 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 №2. You should take the herb of figwort together with the rhizome, blackhead flowers, thyme leaves, and also hawthorn flowers. The following are additional ingredients: kelp thallus, valerian root, and hop cones. All this is taken in equal quantities and prepared according to collection №1.
• Herbal collection №3. It is necessary to acquire bedstraw root, arnica flowers and caper fruits. The auxiliary components are: motherwort herb, catnip, string, knotweed and lemon balm. All ingredients should be mixed together and take only 2 tablespoons of the collection. Prepare and take everything according to collection №1.

Homeopathy

The effectiveness of taking homeopathic medicines depends entirely on the individual characteristics of the organism. The disease itself and its course play a major role in this. Therefore, homeopathy should be used exclusively under the supervision of an experienced specialist.

Hyperthyroidism is characterized by increased thyroid function. This process is accompanied by a decrease or increase in body weight, as well as increased heart rate and increased nervousness. The disease has a strong effect on the cardiovascular, nervous and endocrine systems. It is imperative to treat it. Homeopathic remedies are selected taking into account the individual characteristics of a person and are calculated only for a specific person.

The treatment is completely safe and effective. Its action is aimed at normalizing the thyroid gland. In some severe cases, homeopathic preparations are used together with hormones. This condition is characterized by the selection of drugs using the VRT method. It informatively shows deviations in the functioning of the organ and allows you to choose high-quality treatment.

Surgical treatment

Previously, surgical intervention during pregnancy was widely used. Today, it is recommended to be performed only in extreme cases. Thus, surgical treatment is provided for people suffering from allergic reactions, with intolerance to antithyroid drugs. This also includes people with too large a goiter, as well as with a suspicion of thyroid cancer.

Surgical intervention is necessary when it is necessary to use too high doses of drugs, as well as the occurrence of severe side effects on the part of the body. Finally, this method of treatment is resorted to when a woman does not comply with the prescribed regimen, as well as increased resistance to antithyroid drugs. The question of surgical intervention arises when taking medications does not allow controlling the course of the disease. It is worth noting that surgery can lead to spontaneous abortion and premature birth. Therefore, surgical intervention should be carried out exclusively in the second trimester. The risk of complications at this stage is not so high.

Prevention

Preventive measures include additional iodine intake. It is advisable to increase the daily dose to 200 mg. This will help prevent the development of the disease. The attending physician should select preparations rich in iodine. In this case, it is necessary to take into account the climate, the patient's condition, and the reasons for which hyperthyroidism occurred. Some experts recommend taking food supplements as a preventive measure. In fact, this is not worth doing. There is no precise data regarding the use of iodine in certain products. You can use iodized salt.

Preventive measures should include 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 eliminates the development of pathological processes, but not in all cases. The risk of developing hyperthyroidism still remains. Therefore, expectant mothers should carefully monitor their own health and seek help from a doctor if strange symptoms appear.

Forecast

Even timely treatment of the disease cannot provide accurate data regarding the further condition of the person. In this case, it is almost impossible to predict what the prognosis will be. One thing is clear, the sooner a person seeks help, the higher the chance of successful recovery.

Neither medication nor surgical treatment can accurately predict the prognosis. Therefore, it is necessary to listen to the doctor's recommendations and not ignore them. In this case, the prognosis is much more favorable.

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

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ICD-10 code

Each disease is marked with its own unique code. The International Classification of Diseases makes it easier for doctors around the world. After all, now each disease has its own universal code according to ICD 10, regardless of the city and country.

Thus, hyperthyroidism is also called thyrotoxicosis. It was assigned its own unique code - E05. This subgroup includes - thyrotoxicosis with diffuse goiter under the number E05.0, thyrotoxicosis with toxic uninodular goiter - E05.1, thyrotoxicosis with toxic multinodular goiter - E05.2, Thyrotoxicosis with ectopia of thyroid tissue - E05.3. This also includes: artificial thyrotoxicosis - E05.4, thyroid crisis or coma - E05.5, other forms of thyrotoxicosis - E05.6 and unspecified thyrotoxicosis - E05.7.

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