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Wednesday, 11 December 2013

Hyperthyroidism in Pregnancy - The Possible Complications

Hyperthyroidism is a condition in which the thyroid gland is over active and produces too much thyroid hormones.
Hyperthyroidism during pregnancy mostly happens to younger women and usually is over looked due to the production of hormone HCG (human chorionic gonadotropin) in the first 12 weeks of pregnancy. It is very important that hyperthyroidism is controlled after the 12 weeks of pregnancy, if left untreated, it can increase the risk of miscarriage or birth defect.

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The importance to have hyperthyroidism under controlled in pregnancyIf hyperthyroidism in pregnancy if not under controlled, it can cause the reduced or lost of ability to respond to the normal control by the pituitary gland, causing autoimmune disease, including antibodies include thyroid stimulating immunoglobulin (TSI antibodies), thyroid peroxidase antibodies (TPO), and TSH receptor antibodies that can result of attacking the fetus tissue, including the placenta by the mother immune system.
1. Miscarriage
Miscarriage is defined as the loss of an embryo before the 20th week of pregnancy as it is incapable of surviving independently. In medical terminology, miscarriage is a type of abortion, as it refers to the pregnancy ends with the death and removal or expulsion of the fetus, regardless of whether it is spontaneous or medically induced abortion. In US alone, over 15% of pregnancy ends in miscarriage. According to the article of Harmful Effects of Hypothyroidism On Maternal and Fetal Health Drive New Guidelines for Managing Thyroid Disease in Pregnancy posted on Science news, by Mary Ann Liebert, Inc. (2011, July 25), wrote that Clinical studies are producing critical data demonstrating the harmful effects not only of overt hypothyroidism and hyperthyroidism on pregnancy, but also of subclinical thyroid disease and maternal and fetal health. Ongoing research is clarifying the link between miscarriage and preterm delivery in women with normal thyroid function who are thyroid peroxidase antibody positive. Studies are also uncovering the long-term effects of postpartum thyroiditis.

2. Preterm labor
Preterm labor is defined as the condition in which the uterine contractions of sufficient frequency and intensity to effect progressive effacement and dilation of the cervix prior to term gestation as a result of the affect of the over production of thyroid hormone. In an answer to the question of Could hyperthyroidism have caused my pre-term labor? Dr. Samantha Butts, MD MSCE wrote "Inadequately treated hyperthyroidism has been associated with preterm delivery and other risks in pregnancy. It's possible that your hyperthyroidism was related to your preterm labor, but may not be the only cause. You could also have an incompetent cervix".

3. Low birth-weight babies
In a study of Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism.
Millar LK, Wing DA, Leung AS, Koonings PP, Montoro MN, Mestman JH., researcher found that
Among uncontrolled women compared with those who were controlled during their pregnancies. Elevated TSH-receptor antibody levels were not related to preeclampsia. Maternal thioamide therapy did not adversely affect neonatal outcomes. CONCLUSION:Lack of control of hyperthyroidism significantly increases the risk of low birth weight infants and severe preeclampsia.
4. Stillbirths
According to the aricle of Hyperthyroidism and Pregnancy by WALTER F. BECKER, M.D., PERRY G. SUDDUTH, M.D., researchers indicated that while opinion is divided as to the effect
of thyrotoxicosis on the incidence of abortions, stillbirths, toxemias and certain other complications of pregnancy, there is general agreement that prompt control of the
hyperthyroidism will tend to eliminate whatever influence this factor may have on
the incidence of such complications.

5. Complications of pregnancy, including pre-eclampsia (a condition associated with hypertension, low blood platelet count, protein in the urine and mental changes) and heart failure and Graves' disease.
According to the article of Hyperthyroidism in pregnancy.Diagnosis and management by
BŁAŻEJ MĘCZEKALSKI, ADAM CZYŻYK, researchers indicated that The fetus of the mother with hyperthyroidism is atrisk of many complications, of which a preterm labor as an outcome seems to be the most common. On the otherhand, excess amounts of thyroid hormones may lead togrowth retardation and accelerated bone maturation, and it is associated with an increase in the risk of fetal death. It is proved that even controlled hyperthyroidism is linked to 2 fold higher risk of decline of infants weight, whereas in uncontrolled hypothyroid mothers this risk increases up to 4-9 times, in comparison to the incidence among nonhyperthyroid mothers

6. Etc.

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