Why does the thyroid gland enlarge in pregnant women? Pregnancy and thyroid diseases

Pregnancy is one of the most joyful periods in a woman’s life, however, it does not always go as smoothly as we would like. To bear a baby, colossal changes occur in the mother’s body, and the most global restructuring occurs in the thyroid gland. The structure of the organ itself changes, as does the ratio of the hormones it produces. Is pregnancy possible with a thyroid gland when its indicators differ from the norm in one direction or another?

The thyroid gland is part of the human endocrine system. The organ is located in the neck area on its front surface, its shape strongly reminiscent of a butterfly - it also has two wings and an isthmus between them.

The main cells of the thyroid gland are called thyrocytes, they are responsible for the production of the hormones T4 - thyroxine and T3 - triiodothyronine. The role of these hormones in the human body is very large: they regulate all types of metabolism and most processes of growth and maturation of cells, organs and tissues. During pregnancy, maternal hormones are directly involved in the same processes in the fetus, so their role increases significantly during this period! Provided they are sufficiently concentrated in the blood of a pregnant woman, normal development of all key systems in the fetus is possible.

Thyroid hormones contain iodine, which indicates another important function - collecting and storing iodine in the body. The C-cells contained in the gland produce calcitonin, which regulates calcium metabolism in the body.

Thyroid gland: pregnancy planning

Thyroid dysfunction can affect the speed of a woman's puberty in one direction or another, causing menstrual irregularities, anovulation, infertility or miscarriage.

In women, thyroid diseases occur approximately 15 times more often than in men, therefore, in the process of planning pregnancy or already during infertility treatment, it is necessary to make sure that there are no pathologies. To do this, it is enough to carry out routine laboratory diagnostics, namely a blood test for thyroid hormones.

Thyroid analysis during pregnancy

Regardless of whether a woman is planning a pregnancy or is already pregnant, she needs to prepare for a blood test for thyroid hormones. There is nothing complicated, just a few recommendations:

The test is taken on an empty stomach, so the last meal before blood sampling should take place 12 hours before. During this interval, it is permissible to drink only plain water.
It is better to come to the clinic in advance to sit back and catch your breath.
The evening before the test, you should not drink alcohol, which is, in principle, unacceptable both during pregnancy and when planning it.
Smoking, which also needs to be stopped at the stage of pregnancy planning, is unacceptable an hour before the test.
It is unacceptable to take hormonal pills the day before, as they can greatly distort the results.
On the day before the test, you cannot undergo an ECG, ultrasound, X-ray examination or physiotherapeutic procedures.

Thyroid hormones during pregnancy: which ones to take

Since thyroid hormones during pregnancy have a direct impact on its course and the development of the fetus, every expectant mother must take an appropriate blood test when registering. The laboratory tests the already known hormones T3 and T4. The thyroid-stimulating hormone TSH almost always remains within the normal range, and this is explained by the fact that pregnant women have an increased content of somatotropin, which, in turn, has a stimulating effect on TSH.

If the thyroid gland is pathological, its hormones are examined monthly through blood sampling, and additional studies are prescribed if necessary.

Ultrasound of the thyroid gland during pregnancy

In some cases, a blood test for hormones is not enough, and then the doctor may prescribe an ultrasound of the thyroid gland.

The indicators of this study provide information about changes in the parenchyma - a group of cells in an organ, and about the size of the organ itself. During pregnancy, the thyroid gland increases slightly, and if such an increase occurs by no more than 16% and does not affect the functions of the organ, then no measures are taken. The parenchyma itself must have a homogeneous structure.

If an ultrasound examination reveals nodules, lumps and other formations in the thyroid gland, then consultation with an endocrinologist and additional examinations are necessary.

Ultrasound does not require any special preparation on the part of the patient. During the procedure, the pregnant woman lies on her back; this is not dangerous, since the entire study does not exceed 15 minutes. A special gel is applied to the neck, which facilitates ultrasound examination and displays a clear image on the monitor.

Thyroid puncture during pregnancy

Fine-needle aspiration biopsy - TIAB, or puncture of the thyroid gland allows you to obtain cells from the pathological focus for a thorough laboratory study. This diagnostic method makes it possible to study the structure of the nodes in which the epithelial cells of the gland have transformed into cancer.

A puncture is a puncture of the skin of the anterior surface of the neck, subcutaneous fat and thyroid tissue, which is carried out under careful ultrasound control, followed by the collection of the material necessary for study.

This type of research is carried out in the following cases:

Detection of formations with a diameter of more than 1 cm using ultrasound or simple palpation.
Detection of formations with a diameter of less than 1 cm, if it was determined by ultrasound that the cells had become cancerous, or the woman lives in an area that was exposed to radiation, for example.

The procedure is considered safe, and if necessary, it can be performed on young children, as well as on women during pregnancy or lactation.

Effect of the thyroid gland on pregnancy

The thyroid gland enlarges during pregnancy, and the parenchyma responsible for its functions grows. As a result, hormones begin to be produced in larger quantities, up to 50%.

In the fetus, the process of developing its own thyroid gland occurs from the 12th to the 17th week of pregnancy, and after that it can synthesize important hormones on its own. However, due to the small size of the organ, there are not enough hormones, and therefore their source, as well as the source of iodine, is still the thyroid gland of the expectant mother.

Thyroid norms during pregnancy

The normal functioning of the thyroid gland and the production of a sufficient amount of hormones is important for both the body of the expectant mother and the fetus. During the entire first trimester, the development of all organs and systems occurs, among other things, under the influence of the T3 and T4 hormones of a pregnant woman.

After the fetus's own thyroid gland is formed, maternal hormones continue to be of key importance. Responsibility for the synthesis of iodine throughout pregnancy lies with the thyroid gland of the expectant mother, therefore the need for this trace element increases from 150 mcg to 250 mcg per day during gestation.

Thyroid pathology and pregnancy

With a deficiency of iodine and the hormones T3 and T4 in the mother’s body, she develops a disease called hypothyroidism.

If thyroid hormones are elevated during pregnancy, hyperthyroidism develops, and this condition causes a number of problems for both the pregnant woman and her unborn baby. Most often, this condition is typical for the first trimester, when the influence of the thyroid gland on the course of pregnancy as a whole is maximum. Basically, this reaction is a variant of the normal course of gestation; it goes away on its own and does not require treatment. Then they talk about transient or temporary thyrotoxicosis of pregnancy.

However, in particular cases, it is possible to develop a disease called Graves' or Basedow's disease, and it requires immediate treatment.

Any deviations from the normal functioning of the thyroid gland can be fraught with complications, but there are modern methods of compensation and stabilization for each condition.

Pregnancy with hypothyroidism of the thyroid gland

With hypothyroidism, there is a decreased level of thyroid hormones in the body, as well as iodine deficiency.

If the disease develops during pregnancy, the doctor can identify it by certain signs:

constant fatigue, weakness, lethargy;
excess weight gain;
loss of appetite;
drowsiness;
poor concentration, absent-mindedness;
deterioration of skin, hair and nails;
the appearance of edema, in particular in the area of the face and legs;
low blood pressure;
the occurrence of shortness of breath;
hoarseness of voice.

If a deficiency of T3 and T4 hormones is detected, the doctor prescribes hormone replacement therapy. If hypothyroidism was established at the stage of pregnancy planning, then only with the help of the supply of necessary hormones from the outside can the hormonal balance be restored, and after this it becomes possible to conceive and successfully carry a baby.

If conception has already occurred, but hypothyroidism was not diagnosed for some reason, and, accordingly, hormonal therapy was not prescribed on time, then pregnancy and childbirth with thyroid diseases can be greatly complicated:

miscarriage;
premature birth;
death of the fetus in the womb;
development of serious defects in the baby: deafness, blindness, mental retardation in development.

This is why it is so important to take the necessary blood test and visit an endocrinologist at the stage of pregnancy planning or at least in its early stages.

To prevent the development of hypothyroidism, doctors recommend including moderate amounts of iodized salt, seafood and milk, meat and dried figs in your diet.

Elevated thyroid levels during pregnancy: hyperthyroidism

As already mentioned, in most cases, hyperthyroidism is normal and mostly goes away on its own. Sometimes hyperfunction can still be a pathology.

Hyperfunction of the thyroid gland can be recognized by the following signs:

weight loss;
significant increase in temperature;
increased irritability, overexcitability;
increased blood pressure;
cardiopalmus;
hand tremors;
widening of the palpebral fissures, shine in the eyes;
Possible disorders of the gastrointestinal tract - loss of appetite, abdominal pain, diarrhea.

If hyperthyroidism is not diagnosed in time, the consequences will be as dire as with hypothyroidism:

development of gestosis with all the ensuing consequences;
premature birth;
insufficient weight of a newborn baby;
development of severe defects.

Treatment of hyperthyroidism is aimed at suppressing the function of the thyroid gland, and here one must be extremely careful, because in no case should the gland in the fetus be affected. Therefore, the doctor chooses drugs that are not able to penetrate the placental barrier. It is extremely rare that the question of surgical removal of part of the gland arises. This is possible only in the second trimester of pregnancy with an adequate assessment of the degree of risk and possible damage to the body of the expectant mother and fetus.

Sometimes the development of thyroid disease can occur with the development of large nodular formations, which, if they reach a certain size, become visible to the naked eye. With proper correction of the level of hormones in a woman’s blood, these nodes are not dangerous, but such a pregnancy is carried out under the strict supervision of an experienced endocrinologist. If the nodes reach a size of more than 4 cm, then the question of surgical removal of the gland is raised, but not during pregnancy. During this period, surgery is discussed only when the trachea is compressed.

A disease such as thyrotoxicosis occurs very rarely during pregnancy. In this case, the gland itself remains the same size, but the concentration of hormone levels in the blood exceeds standard values. The symptoms and treatment are the same as for hyperthyroidism.

It is not easy to diagnose hyperthyroidism, and the main difficulty is to distinguish the physiological activity of the gland from the pathological one. As a rule, to establish the disease, doctors prescribe a blood test for hormones and an ultrasound of the thyroid gland.

Thyroid gland after pregnancy

Drowsiness, weakness, and psychological discomfort in a young mother are often attributed to postpartum depression. However, such symptoms may occur due to thyroid dysfunction after childbirth. In this case, we are talking about thyroiditis, which is diagnosed in every 20th woman in the first year after the birth of her baby.

During pregnancy, the immune system weakens its influence so that antibodies do not attack the newly born resident in the mother's womb. After childbirth, it recovers, sometimes in a very dramatic form. Antibodies are produced in large quantities and begin to attack their own cells. Then, in addition to the thyroid gland, other organs also suffer.

Postpartum thyroiditis, PPT, is thus a consequence of excessive activity of one’s own immunity. At risk are, in particular, women with type I diabetes and a history of this disease.

Thyroiditis can occur as hypothyroidism, hyperthyroidism, or hyperthyroidism developing into hypothyroidism.

In the hyperthyroid stage, treatment is usually not required. They can only prescribe beta blockers to normalize the heartbeat. In the hypothyroid stage, thyroid medications are prescribed that are safe for newborn babies.

Pregnancy after thyroid removal

Pregnancy without a thyroid gland is possible only two years after surgery to remove it. During this time, rehabilitation and restoration of the woman’s hormonal balance occurs.

A woman with a removed gland will have to be on hormones all her life, including during gestation. In this case, pregnancy planning is more necessary than ever, with mandatory consultation with an endocrinologist. He will monitor the woman until delivery.

The question of terminating a pregnancy may arise more than once, but it should be remembered that a good psychological attitude in future parents and competent treatment from a good specialist will help achieve the desired result and give birth to a healthy baby!

Thyroid problems during pregnancy: results

It is possible to conceive, carry and give birth to a healthy baby with pathologies of the thyroid gland, and even if it is completely absent after surgery. The most important thing is planning your pregnancy with an experienced and competent specialist, as well as the correct psychological attitude of the spouses and their great faith in a bright future!

Thyroid diseases and pregnancy: video

As a rule, during pregnancy you will need to treat your thyroid gland with special care and attention. As you probably know, this particular internal organ is located directly on the front upper surface of the neck and in its shape can slightly resemble a butterfly with its wings spread. The normal weight of the thyroid gland in an average adult is approximately 20 grams. And despite this, all the hormones that the thyroid gland itself usually produces can have a wide variety of effects directly on the body’s metabolism, normal growth, physical development, and even general intelligence. When they talk about hormones secreted by the thyroid gland, they mean, first of all, thyroxine (or T4) and, of course, triiodothyronine (or T3). And their composition actually includes simple and familiar iodine.

And it is this microelement that is vital so that the thyroid gland itself can normally synthesize all the above-mentioned hormones and naturally in the quantity required for a given organism. If a sufficient amount of these hormones is produced, then normally such an important exchange of carbohydrates, as well as proteins and fats, and vitamins and other minerals should occur. Hormones of this organ are required both for the normal, correct intrauterine development of the nervous system, and for the functioning of the cardiovascular and reproductive systems, as well as for the development of the entire musculoskeletal system, which is why during pregnancy it is extremely important to monitor the general condition of your thyroid gland.

Features of the physiological functioning of the thyroid gland in a pregnant woman

It is always extremely important for a pregnant woman to constantly take an interest in the condition of her own thyroid gland, since this particular organ, with some disruption of its normal functioning, does not hurt at all, and its increase in size can remain completely unnoticed for quite a long time.

The thyroid gland of a pregnant woman always feels a double load, because now, when pregnancy occurs, it works twice as hard for exactly two organisms at the same time. The formation of the thyroid gland in the unborn baby, as a rule, occurs in the fourth or fifth week of its intrauterine development. And already from the twelfth week of pregnancy, it begins to actively function, which means accumulating iodine and accordingly synthesizing the necessary hormones. Directly by the sixteenth or even seventeenth week, this organ is already fully formed and fully and actively functioning. In addition, the only real source of iodine for the already formed full-fledged thyroid gland of the unborn child is precisely the iodine that usually circulates directly in the blood of his mother. And if, for example, a pregnant woman’s diet contains an insufficient amount of such an element as, then the child’s thyroid gland can sharply reduce the production of necessary hormones. And this is already incredibly dangerous due to real disturbances in the development of the unborn baby. Moreover, even if this baby is born physically healthy, his mental abilities may well be somewhat lower than those of all his peers. Actually, this is precisely why we draw a logical conclusion: the daily nutrition of a pregnant woman should be absolutely complete and properly balanced. It is worth remembering that all seafood contains an unusually high amount of iodine: fish, seaweed and much more. Also unusually rich in iodine are fruits such as kiwi, persimmon, and feijoa.

Some of the most common thyroid diseases

So, among the most basic disorders in the normal functioning of the thyroid gland, it is customary to distinguish hyperthyroidism and, of course, hypothyroidism. Moreover, both of these conditions can have an incredibly negative impact directly on the fetus, and on the outcome of the entire pregnancy.

Hyperthyroidism (or thyrotoxicosis) is a sharp increase in the activity of the thyroid gland itself. As a rule, during pregnancy this condition is incredibly dangerous, primarily due to the occurrence of cardiovascular failure and other real complications in a pregnant woman. In addition, this condition is dangerous due to disruptions in the course of future labor, as well as a real risk of some congenital diseases of the same thyroid gland, but in the baby.

And, as a rule, being in this state, a pregnant woman can often feel severe weakness, fatigue, and sometimes a feeling of heat. Fever is also quite possible. And, in addition, a patient diagnosed with hyperthyroidism, as a rule, is extremely irritable, the woman may experience a feeling of fear, and sometimes she is tormented. Also, among the symptoms of hyperthyroidism, doctors also identify a rapid pulse, and some interruptions in the functioning of the heart, and a frequent increase in blood pressure, and muscle weakness, and even trembling of the hands and the whole body. Often there may be a loss of appetite, quite frequent and loose stools, as well as stomach pain, severe sweating, and even hair loss. Hyperthyroidism can also directly affect the appearance of the woman herself - she may experience an unhealthy shine in her eyes, some widening of the palpebral fissures, and even real weight loss.

It should be noted that American scientists have long been able to prove that an excess of hormones secreted by the thyroid gland can have a toxic effect on the human embryo, that is, some kind of self-poisoning of the child’s body occurs. And, of course, if such a condition is not treated, or treated but not quite competently, then it can actually arise. It can also threaten premature birth, developmental defects in the newborn, and even too low a weight in the fetus. Also, with thyrotoxicosis, there can often be a real threat of spontaneous miscarriage (especially in the very early stages of pregnancy) and such a condition as early miscarriage, which, by the way, in this case is extremely difficult, and incredibly difficult to treat even with medication. It must be said that quite often in such situations the pregnancy is even terminated. And as you understand, the earlier in pregnancy and at the stages of the disease it is diagnosed and, therefore, all the necessary measures are taken, the better, of course, the prognosis will be for both the mother and her child.

Pregnant patients with a diagnosis of hyperthyroidism (or thyrotoxicosis) are tried to prescribe drugs that can suppress the functions of the thyroid gland. And in some especially severe cases, even surgery is performed to remove parts of the tissue of the thyroid gland itself. And such an operation, as a rule, is performed no earlier than the second trimester of pregnancy.

Next, let's look at the condition Hypothyroidism - this condition is completely opposite to hyperthyroidism. So, with hypothyroidism, the thyroid gland usually does not work efficiently enough, and as a result, the human body cannot produce the amount of hormones required by the human body. In addition, usually in a state of hypothyroidism, a pregnant woman will complain of general weakness, and a sharp decrease in performance, and even. In addition, a woman in this state will be bothered by constant drowsiness, some depression, and forgetfulness, as well as a sharp decrease in attention and even intelligence. Sometimes sick women notice a real increase in body weight, severe bradycardia and even a decrease in breathing rate; women are worried about dry skin, constant significant hair loss, a constantly roughening voice, nausea, and swelling of the skin. Among other things, hypothyroidism can also suddenly provoke spontaneous miscarriage or intrauterine fetal death; cases of stillbirth or the birth of children with a wide variety of disorders are also quite possible, for example, some mental retardation, deafness, muteness, sometimes strabismus, or dwarfism, etc. .

But in order to be able to avoid all this, doctors try to prescribe an additional dose of a hormone such as thyroxine, and of course carry out active iodine prophylaxis (prescribe drugs that contain potassium iodide).

When a woman is preparing to become a mother, her attitude to health must be attentive, since the body works under great stress. The thyroid gland and pregnancy is something that every expectant mother should remember, since this organ largely determines how successfully this condition will pass.

During pregnancy, a woman’s endocrine system is subjected to increased stress; it produces large quantities of hormones necessary for the body. The amount of hormones increases because it is necessary to provide them not only to the body of the expectant mother, but also to the body of the fetus.

It is clear that the thyroid gland functions with increased intensity during pregnancy, its size may increase, but this phenomenon is temporary. There is no reason to worry in such cases, since after the baby is born everything will quickly return to normal.

This organ belongs to the internal secretion; it produces hormones that are of vital importance, especially thyroxine. Metabolic processes in the body are regulated, so that a person’s intellectual and physical abilities are not impaired.

In order for the organ to function normally, a sufficient amount of iodine is needed, this is important for the normal bearing of a child. If iodine is present in the required amount, then the required amount of a thyroid-type substance is produced, so there are no obstacles to the normal functioning of all human organs.

Such substances play a significant role in ensuring that the fetus in the mother’s womb develops normally, so that there are no problems with the formation of important body systems of the future baby. All this affects the condition of not only the fetus, but also the mother.

Thyroid diseases and pregnancy are the most common phenomenon among other pathological processes that are related to the endocrine system. This has a significant impact on pregnancy. But is it possible to get pregnant with such pathologies? Everything is individual, and the prognosis for diseases is also different. Some things do not threaten future motherhood, while others pose a serious danger. An enlarged thyroid gland often does not mean anything terrible, but there are symptoms that should force a woman to take the necessary measures in time.

It is clear that when a woman soon plans to experience the joy of motherhood, she must carefully monitor the condition of this organ. This is not difficult to do - you need to check the amount of thyroid hormones in the bloodstream in a timely manner and on a regular basis.

Pregnancy planned with thyroid gland

In order for everything to be in order, it is necessary to take care of the condition of the organ at the pregnancy planning stage, and it is even better to do it earlier. The physical and intellectual development of the child depends on the amount of thyroid hormones in the body. If the thyroid gland is enlarged, then the consequences can be different, it all depends on what reasons caused the change in the size of the organ.

It is necessary to undergo an examination of the organ using ultrasound, then the hormonal status can be determined: it can be high or low, but it is better that it corresponds to the norm. If hormonal levels are elevated, the expectant mother should immediately see an endocrinologist. He will determine the cause of the disorder, the necessary therapy and a special diet that contains a large amount of iodine will be prescribed.

Only after all the substances return to normal can you safely go on to conceive a child, if everything is in order in the thyroid gland. There is no need to worry about the thyroid gland, even if it grows in size, but you should definitely undergo a medical examination. If a woman says, I can’t devote so much time to examinations, then everything can end badly, problems with the thyroid gland are serious. And here it is not only an enlargement of the thyroid gland, but the pathology of the thyroid gland can be more serious. The connection between this organ and the reproductive organs is close; with increased hormonal activity, the organ increases in size for various reasons.

Sick thyroid during pregnancy

Pregnancy and female thyroid disease have a significant impact on how this process occurs. At this time, problems with the endocrine system are revealed that were not visible before. At this time, the body undergoes hormonal changes; it occurs in such a way that the fetus is born in the most comfortable conditions.

Children are then born healthy, nothing prevents the baby from developing normally, all conditions are created for the child. But under the influence of pathologies, everything can change.

The thyroid gland and pregnancy involve the following pathologies:

when a woman’s body lacks iodine, a goiter begins to form, which is also influenced by the unfavorable state of the environment. The ecology is in an unsatisfactory condition, ultraviolet and radioactive radiation are active, people work in hazardous production conditions. With goiter, the consequences are negative;
organ tissues undergo an inflammatory process, that is, thyroiditis begins;
the gland begins to function with increased activity, thyrotoxicosis begins;
Tumor-like processes begin to form in the thyroid gland, which are both benign and malignant.

The thyroid gland in healthy pregnant women at the initial stage does not have any serious disorders. Pregnancy and the nodes of the female thyroid gland are interconnected, the latter often begin to change in size.

In some cases, the organ becomes larger in size, this is because the hormonal load is exceeded. But this phenomenon is reversible, so there is no reason to worry.

The thyroid gland is enlarged in pregnant women

As already noted, the organ often increases in size, but this does not always happen for physiological reasons. Pregnancy and various diseases of the thyroid gland can lead to a large size of this organ, various kinds of disorders in the endocrine system, when pathological conditions develop. Often, the expectant mother had certain disorders even before she conceived, but in this state they become obvious.

An enlarged female thyroid gland during pregnancy is observed in the following diseases:

in the presence of hypothyroidism, this pathology occurs in a chronic mode, the functional activity of the organ is inhibited. This disease is difficult to diagnose, since the symptoms of the disease are largely similar to the general symptoms of pregnancy. The woman feels constantly tired, her nerves are out of order, and she constantly feels sleepy. Diagnostics is possible only in laboratory conditions. The danger of such a disease is great - there may be premature birth, the baby is born with anomalies, his endocrine system is affected. The symptoms here can be different, but often the symptoms have much in common with the condition of the expectant mother.
in the presence of thyrotoxicosis, the activity of the organ significantly exceeds the norm, but such pathology is not observed so often in expectant mothers. Problems with conception begin, which entails the inability to become a mother. If you succeed in conceiving a child, then the risk of his being born with pathologies increases significantly.

Nodes in the female thyroid gland during pregnancy can also increase in size, this is influenced by hormones and developing pathologies. Therefore, it is important to know about pathologies even before conceiving a baby is planned, then it is possible to identify and cure all disorders in time.

Absence of the thyroid gland during pregnancy

Such conditions seem strange and even impossible at first, but in fact they can be observed quite often. People whose organs have been surgically removed due to cancer and other serious illnesses. It is possible to plan motherhood in such situations, but this can be done no earlier than a year after all the necessary rehabilitation measures have been completed and if the pathology does not show a relapse.

If such conditions are met, the doctor prescribes hormone replacement therapy, after which the woman will be able to conceive a child. In this case, the patient should be observed by highly specialized specialists in endocrinology and gynecology.

Thyroid nodules during pregnancy

Rarely in this condition do nodes form initially; often a woman already has them; if hormonal levels are elevated, then this situation is almost always observed. Such nodes can be benign or malignant. If they are benign, then there is no danger to the health of the expectant mother and child, but if we are talking about malignant formations, then timely medical intervention is necessary. If we are talking about increased hormonal levels, then such intervention should be immediate. A diseased node can lead to serious problems; such nodes must be dealt with in a timely manner.

If large nodes develop, then this is not a reason to terminate the pregnancy. But in this condition, a woman needs to regularly visit an endocrinologist, take the necessary tests, and undergo appropriate medical therapy so that nodal changes are under constant control.

Thyroid adenoma

We are talking about a benign formation in which the synthesis of thyroid hormones is exceeded. But for this condition no serious problems arise. The problem is that diagnosing an adenoma is difficult, since its symptoms have much in common with the general signs of the health of the expectant mother. A sick woman often doesn’t even understand what’s wrong with her; she doesn’t find any connection with her unhealthy thyroid gland.

If we are talking about a benign neoplasm, then there will be no problems, but if a malignant tumor begins to form, a serious danger arises. In order to detect the very beginning of such a pathology, it is important to undergo a timely examination by an endocrinologist.

Autoimmune type thyroiditis

This disease begins to form due to the inability of the human immune system to recognize its cells; the reasons here are the influence of negative factors. As a result, the thyroid tissue is attacked by the immune system, which negatively affects the woman’s health and the child’s development as well.

If you have autoimmune thyroiditis, you should not plan to conceive a baby; first of all, you undergo special therapy using iodine and hormonal drugs.

Organ removal

Such an organ should not be removed, otherwise the female body will be negatively affected. If a woman is diagnosed with a disease when there is a need to eliminate the endocrine organ, then it is necessary to undergo a medical abortion; premature birth can also be caused.

If sudden changes in hormonal levels are observed, then the pregnancy will proceed normally, not only the health, but also the life of the baby is at risk, so the most radical measures must be taken.

How to treat various pathologies

Effective methods for the listed types of pathologies are methods of conservative therapy. Drug treatment is aimed at ensuring that the condition of the expectant mother is improved and stabilized, and all pathological symptoms are eliminated.

Pregnancy is one of the most difficult stages in a woman’s life. Despite the fact that motherhood is the greatest joy, this period does not always go as we would like. During pregnancy, the body undergoes a complete restructuring: blood flow changes, the center of innervation shifts, and hormonal levels change. The most serious restructuring during pregnancy occurs in the thyroid gland: the internal structure of the endocrine organ changes, as well as the ratio of hormones that it secretes into the blood.

However, pathologies of the thyroid gland during pregnancy are not as dangerous as many may think. Modern medicine makes it possible to carry and give birth to a healthy baby even with diseases of this organ.

The thyroid gland is one of the organs of the human endocrine system. The gland is normally localized on the front surface of the neck, and its shape may remind many of a butterfly, since it has two poles - “wings”, and an isthmus between them. The gland consists of parenchyma and stroma.

The main cells are called thyrocytes. They carry out the main function of the gland - the production of the hormones thyroxine (T4) and triiodothyronine (T3). These are one of the most important hormones in the body, as they are able to regulate all types of metabolism, accelerating or slowing them down, as well as almost all processes of growth and maturation of cells, tissues and organs that occur in the body.

Thyroid hormones contain iodine. This indicates another important function - the accumulation and storage of iodine in the body. It is included in a huge number of enzymes and chemicals that are synthesized in the human body.

In addition to thyrocytes, the gland contains C-cells, which belong to the diffuse endocrine system and produce calcitonin, which regulates calcium metabolism in the body.

Thyroid hormones during pregnancy become of enormous importance for the normal development of the fetus. T3 and T4 are involved in all processes of growth and maturation of cells and tissues. The fetal body is no exception.

The normal development of the nervous, cardiovascular, reproductive, urinary and all other systems of the child is possible only with a sufficient concentration of these hormones in the blood of the expectant mother.

In the first three years after the birth of a baby, hormones obtained from the mother’s body become important for the normal development of the brain, the formation and maintenance of intelligence, since the own thyroid gland in newborn children is not yet functioning.

Thyroid function during pregnancy

The thyroid gland undergoes some changes during pregnancy. There is a physiological increase and proliferation of parenchyma. Thus, more hormones are produced by 30-50%.

It is quite interesting that the fact of an enlargement of the thyroid gland during pregnancy was noticed in ancient Egypt. A rather unusual test was used there. Egyptian women wore the finest silk thread around their necks. If the thread broke, it was considered confirmation of pregnancy.

The process of formation and differentiation of the thyroid gland in the fetus begins already from the 12th week of pregnancy. Final formation occurs by week 17.

From this moment on, the fetal thyroid gland is able to independently synthesize hormones. However, the source of iodine is maternal thyroid hormones. In addition, the mass of the thyroid gland in the fetus is only about 1.5-2 grams, that is, it is unable to fully provide for the baby’s body.

From the above data, several conclusions can be drawn:

Adequate functioning and production of sufficient amounts of thyroid hormones is important for both the mother and the fetus. The development of all organs and systems without exception occurs only with the participation of T3 and T4 of the maternal body. This situation persists until the end of the first trimester. After this, the fetus already differentiates its own thyroid gland, which nevertheless “takes” iodine from the mother’s body, since the body has no other sources of this microelement. Under normal conditions, the daily iodine requirement is 150 mcg, but during pregnancy, this requirement increases to 200-250 mcg. When less iodine is consumed, a disease called hypothyroidism develops.
Excessive hormone production can cause a range of problems for both mother and fetus. Most often, such intoxication is observed in the first trimester of pregnancy, since the influence of the thyroid gland on pregnancy in this trimester is maximum. Thus, a disease develops - hyperthyroidism. In most cases, such a reaction during pregnancy is still considered a variant of the norm, does not require treatment and can go away on its own after some time. Therefore, this type of thyroid hyperfunction is called transient or temporary thyrotoxicosis of pregnancy. But thyrotoxicosis and hyperfunction are not always good; in some cases, a disease develops called Graves' or Basedow's disease, which requires immediate therapeutic intervention and treatment.

A shift in the functioning of the thyroid gland in one direction or another is fraught with complications and dysfunction. But there are modern methods of compensation and stabilization for each individual condition.

Hypothyroidism

Hypothyroidism is a disease characterized by a lack of iodine in the body and, as a result, a lack of hormones. But in some cases, the intake of iodine into the body may not be reduced.

Complaints with hypothyroidism may include the following:

weakness, increased fatigue, weight gain above the norm, feeling of chilliness;
loss of appetite, lethargy, apathy, constant drowsiness, decreased concentration and attention;
dry skin, flaking, hair loss, brittle nails;
the appearance of swelling, especially in the face and lower legs;
the appearance of shortness of breath, decreased blood pressure;
Hoarseness often occurs.

It should be understood that a lack of iodine in the body and decreased thyroid function can occur even before pregnancy. Therefore, it is extremely important to conduct a study of thyroid hormones during planning, and consultation with an endocrinologist is also required.

The doctor, based on the results of the study, prescribes replacement therapy with thyroid hormones - that is, T3 and T4 will enter the body from the outside.

Thus, the hormone levels are corrected and after this you can safely plan conception. In most cases of thyroid hypothyroidism, hormone replacement therapy continues during pregnancy.

With hypothyroidism, the risk of spontaneous miscarriages, premature birth, and death of the baby in utero increases significantly, especially in the early stages.

With a significant decrease in the concentration of thyroid hormones during pregnancy, it can lead to the birth of a baby with developmental defects: mental retardation, deafness, strabismus, etc.

To avoid all these problems, it is necessary to visit an endocrinologist when planning a pregnancy, or directly in the early stages.

Do not neglect vitamin complexes prescribed by your doctor.

Iodized salt or milk are also excellent for prevention, however, do not forget that eating too salty foods is fraught with consequences for a pregnant woman. Many doctors recommend diversifying your diet with seafood.

Sea fish, squid, shrimp, and mussels contain a huge amount of iodine, as do dairy products and meat. Under no circumstances should you get carried away. Another product containing a large amount of iodine is dried figs.

Among other things, it is important to note all the changes occurring in the body. Drowsiness, apathy, brittle hair and nails, dry skin are abnormal signs that accompany pregnancy.

Carrying a child is by no means a disease, so if you pay attention to such symptoms, it is recommended to contact specialists to conduct a detailed study and find out the reasons.

Hyperthyroidism

Just like a decrease in thyroid function, it is possible to increase it. As stated, hyperfunction is physiological in nature to meet the needs of the fetus. But, in some cases, this may be a pathology.

Nodular goiter

Nodular goiter is a whole group of thyroid diseases that occur with the development of large nodular formations. The etiology of the disease is very diverse. In cases of large goiter formation, a cosmetic defect is also possible. Pregnancy and a thyroid nodule are not mutually exclusive.

Nodes are not dangerous if the concentration of hormones in the blood is corrected. Pregnancy, if there are nodules in the thyroid gland, should be carried out under the strict supervision of an endocrinologist. If the nodes are larger than 4 cm, then surgical intervention is necessary, but not during pregnancy. Operations during gestation are carried out only in cases of compression of the trachea.

Symptoms of hyperthyroidism

Increased levels of thyroid hormones in the blood can lead to:

increased fatigue, weight loss, increased temperature, even fever;
increased nervous excitability, irritability, unreasonable feelings of fear, insomnia;
strengthening the functioning of the cardiovascular system, increasing heart rate and blood pressure;
muscle weakness, hand tremors;
possible disorders of the digestive system: loss of appetite, loose stools, pain;
widening of the palpebral fissures and the appearance of shine in the eyes.

The difficulty in diagnosing hyperthyroidism lies in the fact that it is quite difficult to distinguish the physiological norm of increased organ function from pathological activity. Therefore, the following symptoms: low-grade fever, feeling hot, weight loss and vomiting at the beginning of pregnancy should be regarded as possible manifestations of hyperthyroidism and carefully examined.

An increase in pulse above 100 beats per minute, a large difference between the numerical values of systolic and diastolic pressure in most cases indicate the presence of hyperthyroidism. Determination of the level of hormones in the blood and ultrasound of the thyroid gland during pregnancy are of decisive importance in diagnosis.

Hyperthyroidism can cause a number of complications:

gestosis;
fetal malformations;
low baby weight at birth.

Detection of the disease should be carried out in the early stages, then the chances of giving birth to a healthy and strong baby increase significantly.

Therapy for hyperthyroidism is aimed at suppressing gland function. This is where the difficulty arises, since under no circumstances should the fetal thyroid gland be affected. Therefore, during treatment, only minimal concentrations of those agents that are not permeable through the placental barrier are used.

Very rarely it becomes necessary to remove part of the thyroid gland. This operation can only be performed in the second trimester of pregnancy if the risk of complications outweighs the risk of surgery.

Autoimmune processes in the gland

Autoimmune diseases are diseases that arise as a result of the production of antibodies to one’s own cells, that is, the immune system destroys the cells of its own body. Often such diseases are hereditary or caused by mutations.

This pathology is the most difficult from the point of view of pregnancy management, since the therapy of autoimmune processes is based on the use of large doses of steroid drugs and cytostatics, which are contraindicated during pregnancy.

The disease is also complicated by the fact that there is no overproduction of thyroid hormones, which are so necessary for the normal development of the fetus. Treatment can be conservative or surgical.

Conservative is to prevent the development of hypothyroidism by introducing hormones orally. Surgical – resection of the thyroid gland is prescribed only if the mother’s life is threatened.

Thyrotoxicosis

Thyrotoxicosis is a disease accompanied by an increase in the production of thyroid hormones. The main difference from hyperthyroidism is that there is no increase in the gland itself. Thyrotoxicosis during pregnancy is very rare. Symptoms and treatment are the same as for hyperthyroidism.

Thyroid tumors

Thyroid cancer is by no means an indication for termination of pregnancy. With the right approach, it is possible to carry and give birth to a healthy baby in almost all rays.

Treatment is surgical. Removal of thyroid cancer and pregnancy are also not contraindicated. However, most often the operation is postponed until the postpartum period. If this cannot be done, then it is carried out in the second trimester, up to 24 weeks, since the risk of negative effects on the fetus is minimal.

Diagnosis of diseases

Diseases of the thyroid gland during pregnancy are complicated by the fact that many types of diagnostics can harm the fetus, so research must be carried out extremely carefully. The most common diagnostic method, which gives 100% results and is absolutely safe for the fetus, is ultrasound. It is advisable to carry out this study at the slightest suspicion of organ dysfunction.

An ultrasound and a blood test for hormones are 2 irreplaceable studies that will help make an accurate diagnosis in almost all cases.

Pregnancy after surgical removal of the gland

Pregnancy after surgery to remove the thyroid gland is possible, but not earlier than after two years. This period is needed for complete rehabilitation and restoration of the hormonal balance of the female body.

After removal of the thyroid gland, a woman will be forced to be on hormone replacement therapy for the rest of her life, even during pregnancy. Therefore, when planning, it is necessary to consult with an endocrinologist-gynecologist who will manage the pregnancy until childbirth.

Pregnancy and thyroid diseases are closely interrelated. A competent attending physician is the only thing needed in a situation where thyroid pathology is detected during pregnancy.

Pathology of the endocrine organ can seriously affect the health of both mother and baby. Perhaps even more than once during the entire pregnancy the question of the need for termination will arise.

But only thanks to the mother’s psychological attitude and competent treatment can incredible results be achieved.

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The content of the article:

The thyroid gland is one of the most important endocrine organs in humans. It is located on the front surface of the neck, and in an adult it weighs no more than 20 g. But, even despite its small size, the thyroid gland plays a huge role in the functioning of the entire body. Its most basic function is the production of the hormones thyroxine and triiodothyronine. The main composition of these hormones is iodine, and it is necessary in order to control the optimal amount of these components in the human body. In turn, thyroxine and triiodothyronine take an active part in the metabolism of such useful substances in the body as proteins, fats and carbohydrates, and also control the amount of vitamins and minerals necessary for a person. In other words, thanks to the thyroid gland, all vital processes in the body are regulated.

If we take into account the period of pregnancy, then all organs and systems in a woman’s body work differently, including the thyroid gland. In almost all women who are expecting a baby, the thyroid gland enlarges, because it feels a double load. In general, this is considered normal, but it is very important to monitor the condition of this organ throughout pregnancy. Because even if you have any disorders, usually they do not manifest themselves in any way, and the expectant mother will not feel any discomfort.

For the fetus, a healthy thyroid gland plays an important role because it is responsible for the normal development of the cardiovascular, reproductive, nervous system and musculoskeletal system. In the child himself, the formation of the thyroid gland begins at the end of the first month of pregnancy (4–5 weeks). Already at the end of the third month of pregnancy, this organ begins to accumulate iodine in the body and synthesize hormones (thyroxine and triiodothyronine). And at 5–6 months, the thyroid gland functions intensively inside the small organism.

It is in the first trimester of pregnancy that the expectant mother should consume a sufficient amount of iodine in food. After all, if her body experiences a deficiency of this component, the thyroid gland will produce an insufficient amount of hormones. This, in turn, can affect both the physical and mental development of the child.

Causes of enlarged thyroid gland

Despite the fact that during pregnancy, an enlargement of the thyroid gland in some cases is considered normal, there are also other reasons why this problem may appear and be pathological in nature:

iodine deficiency in the body due to an unbalanced diet;
hormonal imbalance in the body;
staying in an area with a contaminated environment or exposure to radiation;
disruption of the functioning of the thyroid gland as a result of operations in this area;
complete or partial absence of the thyroid gland (congenital pathologies or surgical intervention);
malignant and benign tumors.

Treatment and prevention of enlarged thyroid gland

Often pregnant women think that any ailment in their condition is normal, including an enlarged thyroid gland. They are convinced that if they just rest a little and take care of themselves, everything will pass. Unfortunately, this is a very erroneous opinion, because during pregnancy you need to especially carefully monitor your health.

If your doctor suspects you have a problem with an enlarged thyroid gland, he is obliged to send you for additional examination in order to accurately confirm the diagnosis. Also in this case, consultation with an endocrinologist is necessary. Diagnosis of the thyroid gland is carried out using a blood test and ultrasound. There is also an easier way to check whether you have problems with the thyroid gland, namely, whether there is iodine deficiency in your body. This diagnostic method is safe and can be done very easily at home. You need to dip a cotton swab in iodine and draw 2-3 stripes on the elbow or wrist. If these stripes disappear within 24 hours, this is a clear sign of iodine deficiency in the body. Other disorders in the functioning of the thyroid gland must be diagnosed in a medical institution under the supervision of doctors.

After the diagnosis is confirmed, treatment of the pregnant woman should be carried out under the strict supervision of doctors in a hospital. If iodine deficiency is observed with an enlarged thyroid gland, the patient is prescribed medications containing iodine, and the pregnant woman’s menu must be adjusted. The diet should contain foods that are rich in iodine, such as seafood, seaweed, fruits and vegetables (especially tomatoes, eggplants and potatoes).
Adhering to all recommendations, it is also necessary to replace ordinary water with iodized water. And you should cook dishes only with the addition of iodized salt. But it is important to remember that very salty foods are harmful for pregnant women. Therefore, it is important to maintain a certain dose, since an excess of iodine in the body of the expectant mother can cause hyperthyroidism.

If a woman has this pathology, then if this problem is diagnosed in a timely manner, the pregnancy can be saved. In order to suppress the active production of hormones, special medications are prescribed with minimal threat to the fetus. If such treatment does not work, surgery may be performed to remove part of the thyroid tissue. But this type of surgical intervention is possible only in the second trimester of pregnancy.

Consequences of an enlarged thyroid gland during pregnancy

If you monitor the condition of the thyroid gland throughout pregnancy, then the expectant mother and baby will have a completely favorable outcome. Unfortunately, often women expecting a baby do not even suspect that an enlarged thyroid gland can be pathological and cause such phenomena as:

placental abruption and, as a result, premature birth;
frozen pregnancy and spontaneous miscarriage;
stillborn fetus;
intrauterine or postpartum bleeding;
heart failure in a child;
increased blood pressure and arterial hypertension in the mother;
the birth of a child with mental or physical disabilities.

In addition to the problems listed above, a pregnant woman can expect other troubles caused by an enlarged thyroid gland, including hyperthyroidism and hypothyroidism.

Hyperthyroidism is an overactivity of the thyroid gland, as a result of which there is a high risk of disturbances, both in the health of the expectant mother and in the development of the fetus. Quite often there are cases when a child is born with various diseases of the thyroid gland.

With this diagnosis, the following changes may occur in a woman’s condition: disturbances in the functioning of the heart, decreased blood pressure, general weakness, stomach pain, insomnia, weight loss and severe hair loss.

American scientists have conducted a lot of research where they have proven that an excess of hormones that the thyroid gland secretes during pregnancy is very dangerous, since the body is poisoned from the inside. This can certainly affect the fetus, since often women with this diagnosis give birth to babies with various pathologies. As a rule, in dangerous situations, doctors recommend terminating the pregnancy.

Hypothyroidism is a disorder of the thyroid gland in which insufficient amounts of the hormones thyroxine and triiodothyronine are produced. With this diagnosis, pregnant women can often experience miscarriages, premature births, or stillbirths. In addition, children are born with mental or physical disabilities.

With such disorders, a pregnant woman feels weakness, pain in joints and muscles, skin problems, as well as frequent constipation and nausea.

Unlike hyperthyroidism, this diagnosis can be corrected with the help of medications, since iodine deficiency is easier to eliminate than its excess. To do this, the attending physician prescribes medications special for pregnant women containing potassium iodide.

If the treatment was successful, and the pregnancy and childbirth ended favorably for both mother and baby, then this, unfortunately, may not be the end. Often, after being discharged home, an unpleasant phenomenon called “postpartum thyroiditis” can occur. During the recovery process after childbirth, the immune system may not cope and begin to produce antibodies, which, in turn, can destroy thyroid cells. There is a slight enlargement of the thyroid gland, which is generally not dangerous for mother and baby. As a rule, this condition goes away on its own without treatment within 4–6 months. However, even after childbirth, it is very important to be regularly examined by an endocrinologist, which will help eliminate the problem in time. After all, any disturbances in the functioning of the thyroid gland do not manifest themselves internally, where there is a danger of triggering the disease. Also, always follow a proper diet that will contain all the necessary components for your health.

As you can see, both deficiency and excess of iodine are very dangerous for the body, especially when it comes to pregnancy. Therefore, as soon as you see two lines on the pregnancy test, immediately consult a doctor for examination. After all, the sooner you detect some kind of ailment, the greater the likelihood that you and your baby will be healthy. And it’s even better to undergo a mandatory medical examination by key specialists at least once a year, because if you take care of yourself before pregnancy, you won’t have any health problems!

Find out more about changes in thyroid size during pregnancy here: