Hypothyroidism And Pregnancy

by admin on March 12, 2011

Hypothyroidism is six times more common in females as compared to males. Hypothyroidism is prevalent in 5 persons out of 100 persons world wide. Main Causes of hypothyroidism is surgical removal of thyroid which usually we do in hyperthyroidism and in autoimmune diseases.

Clinical Features of hypothyroidism are

Menorrhagia, obesity, dry hairs and skin, hoarseness of voice, decreased heart rate, infertility, anemia, impotency, malar flushing, purple coloured lips, paleness of face, carpal tunnel syndrome etc.hypothyroidism, Hashimoto thyroiditis, Goitre

Investigation: we go for T3 and T4 levels, inorder to differentiate primary hypothyroidism from secondary hypothyroidism we see TSH levels. In Primary hypothyroidism TSH levels are increased and decreased in secondry. We do TPO (Thyroid peroxidase antibodies test) so as to confirm the diagnosis of Hashimoto Thyroiditis.

Drug of choice is thyroxine, however we give preference to levothyroxine as it has long half life, so patient has to take less doses.

Hypothyroidism in Pregnancy: in pregnancy we need to calculate doses again and have to increase the dose of levothyroxine.

Thyroxine therapy can cause heart attack and even myxoedema coma which is a medical emergecny. Till menopause chances of heart attack are less as females are protected by estrogen in their body.

One of our junior asked that does it passes in offsprings, hypothyroidism in pregnancy can cause developmental delay in their children, they may suffer from depression, childs have less IQ as compared to normal mothers.

There is a some evidence that antibodies(seen in Hashimoto thyroiditis) can play some role in pregnancy, these are actually IgG antibodies, which can pass placenta, such mothers are benefited by taking selenium in diet(dose is 60 micrograms in pregnancy and 70 micrograms during lactation.).

Positive Thyroid Peroxidase Test May be Seen in

Rheumatoid arthiritis, SLE, Pernicious Anaemia, Sjogran Syndrome, this test is also known as antimicrosomal antibody test or antithyroid microsomal antibody test.

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