The common thyroid disorders in pregnancy are hypothyroidism and hyperthyroidism. Rarely, nodules and thyroid cancer can also be detected in pregnancy. Women with thyroid diseases are recommended to get optimal control of their thyroid disease before planning for pregnancy. Appropriate control of thyroid diseases in pregnancy reduces the risk of complications.
However, sometimes women are detected to have abnormal thyroid function tests or diseases during pregnancy. It then becomes a concern whether to terminate the pregnancy or continue it. Uncontrolled hypothyroidism in pregnancy is associated with miscarriage, preterm birth, and intrauterine growth restriction. Minor changes in IQ and attention deficits in children have been associated with severe hypothyroidism in the first trimester.
Hyperthyroidism is associated with miscarriages and premature delivery, and antithyroid drugs in pregnancy have been associated with congenital abnormalities.
However, there is no recommendation for medical termination of pregnancy if someone is detected to have thyroid disease in pregnancy. It is advised to
1. Discuss with the endocrinologist to understand the risks associated with your medical condition.
2. Understand what you can do to reduce the risks, such as adjusting medicines or monitoring the fetus.
3. Discuss what can be done before pregnancy for optimal disease control.
Dr. Deepa G MHSc (Diab), Dip (Diab)