Pseudohyperthyroidism during pregnancy

If pseudohyperthyroidism occurs during pregnancy, do not take medications to control the condition at will. You should still do conservative treatment so as not to affect the health of the fetus. Even if you need to take medication, you should first get the consent of a doctor so that you can know whether these medications will cause the risk of abortion. In addition, after suffering from hyperthyroidism, you need more nutrients and need to supplement more food in your diet.

Normal pregnancy is similar to the clinical manifestations of hyperthyroidism in many aspects due to changes in the morphology and function of the maternal thyroid gland, such as tachycardia, increased cardiac output, enlarged thyroid gland, warm skin, sweating, heat intolerance, increased appetite, etc., which are common in both pregnancy and hyperthyroidism.

Mild hyperthyroidism has no obvious effect on pregnancy, but the miscarriage rate, incidence of pregnancy-induced hypertension, premature birth rate, incidence of small-for-term babies and perinatal mortality rate are increased in those with moderate to severe hyperthyroidism and those with uncontrolled symptoms. The reason why hyperthyroidism affects pregnancy is still unclear. It may be because hyperthyroidism causes excessive consumption of nutrients and a high incidence of pregnancy-induced hypertension, which affects the function of the placenta.

During pregnancy, due to the placental barrier, only a small amount of T3 and T4 can pass through the placenta, so it will not cause hyperthyroidism in the neonate. Pregnancy has little effect on hyperthyroidism. On the contrary, pregnancy often relieves the symptoms of hyperthyroidism to varying degrees. However, pregnancy complicated with severe hyperthyroidism can increase the burden on the heart and aggravate the existing heart disease in patients with hyperthyroidism. In some patients, delivery, postpartum bleeding, and infection may induce hyperthyroid crisis.

1. Simple thyroid enlargement during pregnancy

Especially for neurotic pregnant women, their mental and emotional manifestations are very similar to those of pregnant women with hyperthyroidism, but the pulse is <100 times/min, the pulse pressure difference is <50mmHg (6.7kPa), the palms are cold, there is no slight tremor, the knee reflex is normal, the thyroid enlargement is not significant, there is no vascular tremor or audible murmur, and there is no staring or exophthalmos. Laboratory serum examinations showed that all thyroid function indicators were within the normal range for pregnancy.

2. Subacute thyroiditis

(1) Hyperthyroidism: This is the most common thyroid disease in adolescents or older pregnant women during pregnancy. Patients often have clinical manifestations of hypermetabolism, such as palpitations, heat intolerance, sweating, mental tension, irritability, hand tremors and other symptoms of hyperthyroidism. Serum TT4, TT3, FT4, FT3, etc. are all elevated, so the patient is often misdiagnosed and given ATD treatment. However, patients often have a history of viral infection, sudden onset, chills and fever. The most characteristic symptoms are thyroid enlargement and pain. The swelling and pain may start on one side, then spread to the other side, and then affect the entire thyroid gland. The diseased gland is hard and tender, and the pain worsens with chewing, swallowing, turning the neck or lowering the head. The erythrocyte sedimentation rate is significantly accelerated (50-100 mm/h).