Unexpected pregnancy in patients with hyperthyroidism is a very complicated problem to terminate or continue pregnancy. It is necessary to comprehensively consider the patient’s condition, physical condition, and current treatment plan.
During pregnancy, hyperthyroidism will increase the possibility of fetal abortion, premature birth, growth and development, and will cause pregnant mothers to suffer from hypertension, heart failure, prenatal euction, etc.
Both methemothidazole and propyl oxymidine may cause fetal malformations, especially at 6-10 weeks of pregnancy.The fetal deformity caused by metimolidazole is mainly skin development and "hybolitic diseases related to metalazole", including posterior nasal holes, esophageal locks, and facial deformities.The incidence of malformations related to propyl oxyraine is equivalent to methimimol, but the degree is lighter.
Patients with hyperthyroidism are unexpectedly pregnant. Please go to the hospital for the first time. The doctor will evaluate it based on the test results.Generally speaking, the more severe the thyroid enlargement, the greater the dose of the drug, the greater the impact on the fetus, and the more difficult treatment is.
In the early stages of pregnancy, hyperthyroidism and early pregnancy reactions will cause pregnant mothers to have severe nausea and vomiting symptoms, affecting the treatment effect of the drug; and the uncontrolled hyperthyroidism will increase the above discomfort and form a vicious circle.If it is a patient with a long period of hyperthyroidism, and cardiovascular complications have already occurred, such as severe heart rate, incomplete heart function, etc. As the number of pregnancy weeks increases, the heart burden of pregnant women will increasedecline.
If the pregnant mother is being treated with anti -thyroid drugs, the thyroid function and Trab need to be detected immediately, and the thyroid function is closely monitored in the early pregnancy.According to the levels of FT4 and T3, decide whether to apply drugs for drug treatment, and try to discontinue the drug before the critical period of terators (6 ~ 10 weeks of pregnancy).
The biggest disadvantage of hyperthyroid drug treatment is that it is easy to relapse after stopping the drug. Most patients relapse at 0.5 to 1 year after the drug discontinuation, and the larger the thyroid recurrence rate, the higher the TRAB cost, the higher the recurrence rate.
Therefore, if patients with hyperthyroidism are pregnant, please go to the hospital for treatment as soon as possible. The doctor will conduct a comprehensive assessment based on your condition to escort the health of you and the fetus.
Depending on the patient’s condition and treatment, the time to prepare for pregnancy is also different:
1) The thyroid gland is not large or mild. After 1 to 2 years of treatment, the use of minimum dose of drugs has been maintained for more than half a year.La;
2) Patients who receive 131i treatment will disappear after half a year, and have no effect on ovarian function. They can also start pregnancy within six months to one year after treatment, but they need to be alert to secondary hypothyroidism;
3) If surgery is used to treat hyperthyroidism, you can consider pregnancy for 3 months after surgery.
references:
[1] Ma Liangkun. What should I do if 263 pregnancy and thyroid diseases [M]. China Union Medical University Press, 2014.
[2] Guidelines for diagnosis and treatment of thyroid disease in pregnancy and postpartum (2nd edition). China Endocrine Magazine 2019 AUG; 35 (8)
瑞 Source of this article: Koritai Q Medical Brand Operation Center
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