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Pregnant with hyperthyroidism

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a year ago I was diagnosed with hyperthyroidism. However, I didn't really have the typical symptoms of hyperthyroidism, like weight changes, heart palpitations, and nervousness, so I took the pills for a couple of months and stopped. Now I am pregnant for a month. I really want to keep the baby, but I am worried the health of the unborn baby. I didn't take pills to cure hyperthyroidism during the first month of pregnancy and even before being pregnant. So doctor, can I keep the baby? If I can, what should I do to keep the baby healthy and being uninfluenced by my hyperthyroidism?

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Category: Family Physician-GP
 27 Doctors Online

Hello, With reference to your query (being already Hyperthyroid) and now you are pregnant for about a month without hyperthyroid symptoms and wants to keep the baby and also about its health. If you are already diagnosed as Hyperthyroid and also on treatment, your dosage will be adjusted so that T4 levels remain in the normal range for some one who is not pregnant. There is a risk of disease worsening during the first trimester or in the early post partum period, however women may have better control of hyperthyroidism during pregnancy. The antithyroid drug is propyethionavil (especially during the 1st trimester), because methimazole has a slightly higher risk of birth defects. Methimazole will be used for the second and third trimesters. If you develop severe negative reaction to antithyroid drugs, requires very high doses to control the hyperthyroidism or uncontrolled hyperthyroidism despite treatment surgery may be recommended which will be during the second trimester when it is least likely to endanger the pregnancy. Radioactive iodine should never be given. TSH receptor stimulating or binding antibodies in the mother can cross the placenta and affect the baby’s thyroid. If a woman is positive for these antibodies during pregnancy, the baby can be born with hyperthyroidism or Hyperthyroidism. Treatment of the mother with antithyroid drugs may be necessary to reduce the risk to the newborn. If a woman with increase in TSH receptor stimulating or TSH receptor binding antibodies is treated with antithyroid drugs, fetal ultrasound evaluation should be conducted and look for evidence of thyroid dysfunction in the developing baby including slow growth and enlarged thyroid, among other signs. Free T4 above the reference range and TSH loss than 0.1 mu/m. l may require treatment. The result would be either unsuccessful termination by miscarriage or premature birth in about 50%. It depends on the severity of the disease at the time of pregnancy. Since you are in the first trimester, you better discuss in detail with your GP about the possible effects on you and the baby if you decide to have it. Because your GP can decide which will be the best course of action at present. Thank you.

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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