When hyperthyroidism occurs during pregnancy, beware of hyperthyroidism crisis

Author: Huang Guiling

First review: Tai Jing

Final judge: Zhao Yinlong

On this day, the laboratory work was going on very busy. Just as I was concentrating on reviewing each report, a test report with all upward arrows stopped me. Multiple tumor markers were abnormally elevated, and the serum HCG value was 5261.957. "Is this a pregnant woman? She's 25 years old! Why are so many indicators abnormal? Tumor or something else?" A series of questions flashed through my mind. Whatever the disease was, this patient must be in a serious condition. So I quickly looked through the medical records.

The patient was a young woman, 27 weeks pregnant , who was admitted to the hospital due to "chest tightness, shortness of breath for 3 hours, and cardiac arrest for more than 2 hours" . The cardiac arrest was successfully resuscitated, but her condition was critical, with multiple organ failure, acute renal failure, liver dysfunction, shock, sepsis, lactic acidosis, hypokalemia, intrauterine fetal death, and anemia. The culprit of all this was gestational thyroid crisis . Fortunately, after many days and nights of hard work by medical staff from multiple departments, the patient was finally out of danger. For the life and health of pregnant women and fetuses, it is important to understand the true face of gestational thyroid crisis.

What is thyroid storm in pregnancy?

Hyperthyroidism crisis during pregnancy is a serious complication of pregnant women with hyperthyroidism. Because the thyroid gland suddenly releases a large amount of thyroid hormone, the metabolic process of the whole body becomes abnormally active, and the patient will experience tachycardia, heart failure, irritability, anxiety, delirium, coma, nausea, vomiting, abdominal pain, diarrhea, unexplained jaundice, dehydration, rapid weight loss, electrolyte imbalance, hypoglycemia, liver and kidney failure, and other symptoms, and the condition will rapidly deteriorate.

What are the main causes of thyroid storm during pregnancy?

Failure to take regular treatment or adherence to antithyroid drugs, infection, diabetic ketoacidosis, severe mental stimulation, pregnancy and childbirth, trauma, cardiovascular and cerebrovascular diseases, etc. may induce gestational thyroid crisis. The patient in this case was found to have hyperthyroidism during pregnancy, but she did not take medication regularly, which led to hyperthyroid crisis.

Hyperthyroidism crisis during pregnancy is so dangerous, how can we prevent it?

1. Hyperthyroidism should be cured before preparing for pregnancy.

2. If hyperthyroidism is not cured and you become pregnant, you should follow the doctor's advice and take antithyroid drugs regularly.

3. Appropriately increase the frequency of prenatal examinations and closely follow up changes in thyroid function.

4. Emotional fluctuations and stress may affect the condition of hyperthyroidism, so managing emotions and adjusting your mindset can help prevent hyperthyroidism crisis.

5. Avoid overwork.

6. Avoid excessive iodine intake during pregnancy, as excessive iodine will stimulate thyroid function. Maintain a balanced diet and take in adequate nutrition.

During pregnancy, hyperthyroidism crisis mainly occurs during the peripartum period, during the induction of labor in mid-pregnancy, and during the perioperative period of cesarean section. For those with a clear history of hyperthyroidism, they should be highly alert to the occurrence of hyperthyroidism crisis based on its causes and typical symptoms such as high fever, sweating, and tachycardia. Hyperthyroidism crisis in pregnancy develops and develops rapidly, is dangerous, and endangers the life of the mother and fetus in severe cases. Therefore, it is extremely important to understand the early signs of hyperthyroidism crisis in pregnancy and identify the clues early. I hope that pregnant mothers will pay more attention to thyroid health for themselves and their babies!