What are the precautions for hyperthyroidism during pregnancy and childbirth?

Many women will have a big appetite after becoming pregnant and become very good at eating. Under normal circumstances, this is a normal reaction. However, if at this time there is also a rapid heartbeat, frequent shortness of breath, and no gain of weight no matter how much they eat, then you should pay attention, as the pregnant woman may suffer from hyperthyroidism. Although pregnancy will not cause hyperthyroidism to worsen, it is recommended that women wait until their hyperthyroidism is cured before becoming pregnant. If pregnancy and hyperthyroidism occur at the same time, they can be maintained with small doses of medication. Now let’s talk about what to pay attention to when getting pregnant and having a baby with hyperthyroidism.

Note 1:

Treatment is mainly with oral medication, with propylthiouracil (PTU) being the first choice. However, the maximum dose should be less than 200 mg per day, with 50-150 mg per day being appropriate, because large doses may damage the fetal thyroid development. If symptoms are still difficult to control, drugs such as propranolol may be added as appropriate. This is the most important hyperthyroidism precaution for pregnant women.

Note 2:

Precautions for pregnant women with hyperthyroidism also include that the disease should be controlled moderately. It is not necessary to completely control observation indicators such as heart rate, basal metabolic rate, thyroid function tests (T3, T4) to the normal range, because even for normal pregnant women, the above observation indicators will be slightly higher than the normal range. Controlling the disease too low will cause hypothyroidism in mother and child.

Note three:

Pregnant women with hyperthyroidism should not use thyroid iodine-131 uptake tests, and should not use isotopes to treat hyperthyroidism, so as not to affect the growth and development of the fetus. If the doctor decides that surgical treatment is necessary, it should be done in the 4th to 6th month of pregnancy, and the hyperthyroidism condition must be controlled before the operation. The mother needs to increase the frequency of checkups during pregnancy to understand the development of the fetus, and report any abnormalities to the doctor in a timely manner. The concentration of thyroid receptor antibodies (TRAb) must be measured regularly during pregnancy. If TRAb is several times higher than the normal value, it indicates that the fetus may also suffer from hyperthyroidism, so that the doctor can take timely measures. A uterine B-ultrasound examination must be performed before delivery to determine whether the fetus has thyroid enlargement or other malformations and to prevent dystocia. You must stop taking the medicine for at least 3 weeks after delivery before breastfeeding.