Hypothyroidism in Pregnancy

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/
Hypothyroidism affects 1% of pregnant patients. Defining symptoms of hypothyroidism include;

cold intolerance,

slow heart rate(Bradycardia) ,

delayed relaxation of tendon reflexes,
excessive menses (in non pregnant ) 

The most common cause of hypothyroidism is autoimmune.

Hypothyroidism is diagnosed with reduced free T4 concentration with increased TSH levels.

Most serious consequence of hypothyroidism in pregnancy is Myxedema Coma which is a medical emergency. Neuropsychiatric development is delayed in offsprings born to hypothyroid mothers . However correction of maternal hypothyroidism in first 12 wks of pregnancy might improve outcome.

Cretinism (deaf mutism, spastic motor disorders & hypothyroidism ) is distinct & severe form of brain damage caused by severe maternal iodine deficiency .

Patients with hypothyroidism should be counselled to delay pregnancy until maintenance level of T4 is achieved.

Hypothyroid in pregnancy requires treatment with thyroxine with thyroid function tests repeated every 3 months ( however they should be repeated every 4-6 wks if dosage changes are to be made).