Pregnancy is one of the most joyful periods in a woman's life, however, it does not always go as smoothly as we would like. For bearing a baby, colossal changes take place in the mother's body, and the most global restructuring occurs in the thyroid gland. The structure of the organ itself changes, as does the ratio of hormones produced by it. Is pregnancy possible with a thyroid gland, when its indicators differ from the norm in one direction or another?

Thyroid is part of the human endocrine system. The organ is located in the neck area on its front surface, strongly resembling a butterfly in shape - it also has two wings and an isthmus between them.

The main cells of the thyroid gland are called thyrocytes, they are responsible for the production of the hormones T4 - thyroxine and T3 - triiodothyronine. The role of these hormones in the human body is very large: they regulate all types of metabolism and most processes of growth and maturation of cells, organs and tissues. During pregnancy, maternal hormones are directly involved in the same processes in the fetus, so their role increases significantly during this period! Subject to their sufficient concentration in the blood of a pregnant woman, it is possible normal development all key systems in the fetus.

Thyroid hormones contain iodine, which indicates another important function of them - the collection and storage of iodine in the body. C-cells contained in the gland produce calcitonin, which regulates calcium metabolism in the body.

Thyroid gland: pregnancy planning

Thyroid dysfunction can affect the speed of a woman's puberty in one direction or another, cause a violation menstrual cycle, anovulation, infertility or miscarriage.

In women, thyroid diseases are about 15 times more common than in men, therefore, in the process of planning a pregnancy or already during infertility treatment, it is necessary to make sure that there are no pathologies. To do this, it is enough to carry out the usual laboratory diagnostics, namely a blood test for thyroid hormones.

Thyroid test during pregnancy

Regardless of whether a woman is planning a pregnancy, or is already in a position, she needs to prepare for a blood test for thyroid hormones. Nothing complicated, just a few recommendations:

1. The analysis is taken on an empty stomach, therefore the last meal before blood sampling should take place 12 hours before. During this interval, it is permissible to drink only plain water.
2. It is better to come to the clinic in advance to sit out a little and catch your breath.
3. On the evening before the analysis, you should not drink alcohol, which is in principle unacceptable both during pregnancy and when planning it.
4. Smoking, which must also be abandoned already at the stage of pregnancy planning, is unacceptable one hour before the test.
5. The day before, the use of hormonal pills is unacceptable, as they can greatly distort the result.
6. On the day before the analysis, you can not undergo an ECG, ultrasound, X-ray examination or physiotherapy procedures.

Thyroid hormones during pregnancy: what to take

Since thyroid hormones during pregnancy have a direct impact on its course and the development of the fetus, each expectant mother must take an appropriate blood test when registering. In the laboratory, the hormones T3 and T4 already known to us are checked. The thyroid-stimulating hormone TSH almost always remains within the normal range, and this is explained by the fact that pregnant women have an increased content of somatotropin, which, in turn, has a stimulating effect on TSH.

In case of thyroid pathology, its hormones are examined monthly through blood sampling, and additional studies are prescribed if necessary.

Ultrasound of the thyroid gland during pregnancy

In some cases, there is not enough blood test for hormones, and then the doctor may prescribe an ultrasound of the thyroid gland.

The indicators of this study give an idea about the changes in the parenchyma - a group of cells of the organ, about the size of the organ itself. During pregnancy, the thyroid gland increases slightly, and if such an increase occurs by no more than 16%, and does not affect the functions of the organ, then no measures are taken. The parenchyma itself must be of a homogeneous structure.

If, when researching with ultrasound diagnostics nodes, seals and other formations in the thyroid gland were identified, then an endocrinologist's consultation and additional examinations are necessary.

Ultrasound does not require any special preparation on the part of the patient. During the procedure, the pregnant woman is laid on her back, this is not dangerous, since the entire study does not exceed 15 minutes. Apply to the neck special gel, which contributes to the implementation of ultrasonic standards and the display of a clear picture on the monitor.

Puncture of the thyroid gland during pregnancy

Fine-needle aspiration biopsy - TIAB, or puncture of the thyroid gland allows you to get the cells of the pathological focus for a thorough laboratory study. This diagnostic method makes it possible to study the structure of the nodes in which the epithelial cells of the gland have been transformed into cancer cells.

A puncture is a puncture of the skin of the anterior surface of the neck, subcutaneous fat and thyroid tissue, which is carried out under careful ultrasound control, followed by the collection of the material necessary for study.

This type of research is carried out in the following cases:

1. Detection of formations with a diameter of more than 1 cm using ultrasound or simple palpation.
2. Detection of formations with a diameter of less than 1 cm, if, at the same time, the degeneration of cells into cancer cells was established by means of ultrasound, or the woman lives in an area that has been exposed to radiation exposure, for example.

The procedure is considered safe, and if necessary, it can be performed in young children, as well as in women during pregnancy or lactation.

The influence of the thyroid gland on pregnancy

The thyroid gland during pregnancy increases, the parenchyma grows, which is responsible for its functions. As a result, hormones begin to be produced in larger quantities, up to 50%.

In the fetus, the process of laying its own thyroid gland occurs from the 12th to the 17th week of pregnancy, and after that it can already synthesize important hormones on its own. However, due to the small size of the organ, there are not enough hormones, and therefore their source, as well as the source of iodine, is still the thyroid gland of the expectant mother.

Thyroid norms during pregnancy

The normal functioning of the thyroid gland and the production of a sufficient amount of hormones has importance both for the body of the expectant mother and for the fetus. Throughout the first trimester, the development of all organs and systems occurs, among other things, under the influence of the hormones T3 and T4 of a pregnant woman.

After the fetus's own thyroid gland is formed, it is maternal hormones that are still of key importance. Responsibility for the synthesis of iodine throughout pregnancy lies with the thyroid gland of the future mother, because the need for this trace element increases from 150 mcg to 250 mcg per day during gestation.

Thyroid disease and pregnancy

With a deficiency of iodine and the hormones T3 and T4 in the mother's body, she develops a disease called hypothyroidism.

If thyroid hormones are elevated during pregnancy, then hyperthyroidism develops, and this condition causes whole line problems for both the pregnant woman and her unborn baby. Most often, this condition is typical for the first trimester, when the influence of the thyroid gland on the course of pregnancy as a whole is maximum. Basically, this reaction is a variant normal flow gestation, it passes on its own and does not require treatment. Then they talk about transient or temporary thyrotoxicosis of pregnancy.

However, in particular cases, the development of a disease called Graves' or Basedow's disease is possible, and it already requires urgent treatment.

Any deviations from the normal functioning of the thyroid gland can be fraught with complications, but there are modern ways compensation and stabilization for each state.

Pregnancy with hypothyroidism

With hypothyroidism, there is a reduced content of thyroid hormones in the body, as well as iodine deficiency.

If the disease develops during pregnancy, the doctor can identify it by some signs:

• constant fatigue, weakness, lethargy;
• excess weight gain;
• loss of appetite;
• drowsiness;
• poor concentration, distraction;
• deterioration of the skin, hair and nails;
• the appearance of edema, in particular, in the area of ​​\u200b\u200bthe face and legs;
• low blood pressure;
• the occurrence of shortness of breath;
• hoarseness of voice.

If a deficiency of T3 and T4 hormones is detected, the doctor prescribes hormone replacement therapy. If hypothyroidism was established at the stage of pregnancy planning, then only with the help of the supply of necessary hormones from the outside it is possible to restore the hormonal balance, and after that it becomes possible to conceive and successfully bear a baby.

If conception has already occurred, and for some reason hypothyroidism has not been established, and, accordingly, hormonal therapy was not prescribed on time, then pregnancy and childbirth with thyroid diseases can be greatly complicated:

• miscarriage;
• premature birth;
• death of the fetus in the womb;
• the development of serious defects in the baby: deafness, blindness, mental retardation in development.

That is why it is so important to pass the necessary blood test and visit the endocrinologist at the stage of pregnancy planning, or at least at her early dates.

To prevent the development of hypothyroidism, doctors recommend including in your diet moderately iodized salt, seafood and milk, meat and dried figs.

Elevated thyroid levels during pregnancy: hyperthyroidism

As already mentioned, in most cases, hyperthyroidism is normal phenomenon, mostly on its own. Sometimes hyperfunction can still be a pathology.

An overactive thyroid gland can be recognized by the following signs:

• weight loss;
• a significant increase in temperature;
• increased irritability, overexcitability;
• increased blood pressure;
• heart palpitations;
• hand tremor;
• expansion of the palpebral fissures, shine in the eyes;
• possible violations by gastrointestinal tract- loss of appetite, abdominal pain, diarrhea.

If hyperthyroidism is not diagnosed in time, the consequences will be as dire as with hypothyroidism:

• the development of preeclampsia with all the ensuing consequences;
• premature birth;
• underweight newborn baby;
• development of severe defects.

The treatment of hyperthyroidism is aimed at suppressing the function of the thyroid gland, and here one must be extremely careful, because in no case should the gland in the fetus be affected. Therefore, the doctor chooses drugs that are not able to penetrate the placental barrier. It is extremely rare that the question of surgical removal of part of the gland arises. This is possible only in the second trimester of pregnancy with an adequate assessment of the degree of risk and possible damage to the body of the expectant mother and fetus.

Sometimes the development of thyroid disease can proceed with the development of large nodular formations, which, if a certain size is reached, become visible to the naked eye. With the correct correction of the level of hormones in the blood of a woman, these nodes are not dangerous, but such a pregnancy is carried out under the strict supervision of an experienced endocrinologist. If the nodes reach a size of more than 4 cm, then the question of surgical removal of the gland is raised, but not during pregnancy. During this period, we are talking about the operation only when the trachea is compressed.

Very rarely during pregnancy, a disease such as thyrotoxicosis occurs. At the same time, the gland itself remains previous sizes, but the concentration of hormones in the blood exceeds the standard values. Symptoms and treatment are the same as for hyperthyroidism.

It is not easy to diagnose hyperthyroidism, and the main difficulty lies in distinguishing the physiological activity of the gland from the pathological one. As a rule, to establish the disease, doctors prescribe a blood test for hormones and an ultrasound of the thyroid gland.

Thyroid after pregnancy

Drowsiness, weakness, psychological discomfort in a young mother are often attributed to postpartum depression. However, such symptoms can occur against the background of a malfunction of the thyroid gland after childbirth. In this case, we are talking about thyroiditis, which is diagnosed in every 20th woman in the first year after the birth of her baby.

During pregnancy, the immune system weakens its influence so that antibodies do not attack the new tenant in the womb of the mother. After childbirth, it is restored, sometimes in a very sharp form. Antibodies are produced in in large numbers and start attacking their own cells. Then, in addition to the thyroid gland, other organs also suffer.

Postpartum thyroiditis, PRT, thus, is a consequence of the excessive activity of the work of one's own immunity. At risk are, in particular, women with type I diabetes and already having this disease in their anamnesis.

Thyroiditis can occur as hypothyroidism, hyperthyroidism, or hyperthyroidism flowing into hypothyroidism.

In the hyperthyroid stage, treatment is usually not required. They can only prescribe beta-blockers that normalize the heartbeat. At the hypothyroid stage, thyroid drugs are prescribed that are safe for the newborn baby.

Pregnancy after thyroidectomy

Pregnancy without a thyroid gland is possible only two years after the operation to remove it. During this time, rehabilitation and restoration of hormonal balance in a woman takes place.

A woman with a removed gland will have to be on hormones all her life, including during gestation. In this case, pregnancy planning is more necessary than ever, with a mandatory consultation with an endocrinologist. He will observe the woman until delivery.

The question of terminating a pregnancy may arise more than once, but it should be remembered that future parents have a good psychological attitude and competent treatment for a good specialist will help to achieve the desired result and give birth to a healthy baby!

Thyroid problems during pregnancy: results

It is possible to conceive, endure and give birth to a healthy baby with pathologies of the thyroid gland, and even with its complete absence after surgical intervention. The most important thing is planning your pregnancy with an experienced and competent specialist, as well as the right psychological attitude of the spouses and their great faith in a brighter future!

Thyroid disease and pregnancy: video

The thyroid gland is a butterfly-shaped gland weighing 15-20 g, which is located on the front surface of the neck in its lower third. The thyroid gland produces hormones such as thyroxine(T4) and triiodothyronine(T3). In the blood, most of the thyroid hormones are found in bound state with a carrier protein and is inactive, while only a small free fraction of hormones is active and performs its functions.

The function of the thyroid gland is under the control of the hypothalamic-pituitary system. synthesized in the hypothalamus thyrotropin-releasing hormone(TRG). This hormone, getting into the pituitary gland, stimulates the formation thyroid-stimulating hormone(TSH), which in turn stimulates the activity of the thyroid gland and the formation of T4 and T3. Thyroid hormones are involved in almost all body processes, regulating metabolism, the synthesis of vitamins (vitamin A in the liver), and also take part in the implementation of the function of other hormones in the body.

Diseases of the thyroid gland are accompanied by both a decrease and an increase in its function. These diseases can affect the nature of the course and outcome of pregnancy, as well as the condition of the newborn. However, with timely detection and correction, almost any pathology of the thyroid gland is not a contraindication to planning and prolonging pregnancy. Pregnancy rarely develops against a background of severe endocrine pathology, since it often leads to impaired reproductive function and infertility.

Most commonly diagnosed during pregnancy diffuse enlargement of the thyroid gland(goiter) with preservation of euthyroidism and autoimmune thyroiditis leading to change hormonal background in organism. During pregnancy, there is a change in the functional state of the thyroid gland, which must be taken into account when assessing its condition. In this regard, for the correct interpretation of laboratory parameters reflecting the activity of the thyroid gland, it is important to take into account the following: combined determination of the level of TSH and free T4 is necessary; determination of total T4 and T3 is not informative, since during pregnancy their levels are always increased by 1.5 times; the amount of TSH in the first half of pregnancy is normally reduced in 20-30% of women with a singleton and in 100% with multiple pregnancy; free T4 in the first trimester is slightly elevated in about 2% of pregnant women and in 10% of women with suppressed TSH; the level of free T4, determined by later dates pregnancy, it is borderline reduced with normal amount TSH; to monitor the effectiveness of the treatment of thyroid pathology, a combined determination of the level of free T4 and TSH is used, and in the case of treatment in a pregnant thyrotoxicosis- only one level of free T4.

For the diagnosis of autoimmune pathology of the thyroid gland, it is advisable to study only antibodies to thyroid peroxidase (AT-TPO). Carriage of Ab-TPO is a common phenomenon in the population, far from always having a pathological significance, however, in women carriers of antibodies to TPO, postpartum thyroiditis develops in 50% of cases. To assess the functional state of the thyroid gland during pregnancy, in addition to hormonal studies, an echographic examination (ultrasound of the thyroid gland) and a fine-needle aspiration biopsy can be used.

Iodine deficiency diseases

Iodine deficiency diseases are pathological conditions that develop due to a lack of iodine and can be prevented by normalizing iodine intake. According to WHO, 30% of the world's population has iodine deficiency diseases. Iodine is necessary component thyroid hormones. Normally, the body of pregnant women should receive daily 200 micrograms of iodine. A decrease in iodine intake during pregnancy leads to chronic stimulation of the thyroid gland, a relative decrease in the level of thyroxine in the blood and goiter formation in both mother and fetus .

In such patients, children with mild psychomotor disorders are more often born, the risk of a complicated course of pregnancy increases, which manifests itself in the form of spontaneous abortions, premature births, congenital malformations of the fetus, and complications in childbirth. Children who are born often have a decrease in thyroid function and mental retardation. Most clear manifestation iodine deficiency and insufficient intake of iodine in the body is a diffuse euthyroid (non-toxic) goiter - a diffuse enlargement of the thyroid gland without disturbing its function. The term is also used to refer to goiter caused by iodine deficiency. "endemic goiter". Enlargement of the thyroid gland in iodine deficiency is a compensatory reaction to ensure the synthesis of a sufficient amount of thyroid hormones in conditions of iodine deficiency. The second most common manifestation of iodine deficiency is the development nodular goiter .

Inadequate intake of iodine in the body is determined using various methods research. Determination of the content of TSH and thyroglobulin in the blood serum, as well as ultrasound of the thyroid gland help to objectively assess the severity of the pathology. The functional state of the thyroid gland is determined by the level of free T4 and T3 and TSH in serum. Most effective method replenishment of iodine deficiency is the use of iodized table salt. Since pregnancy is the period of the greatest risk of developing severe iodine deficiency diseases, already at the stage of its planning, it is advisable for women to prescribe individual iodine prophylaxis with physiological doses of iodine - 200 mcg per day in the form of precisely dosed drugs (Iodomarin, Iodide 100/200) or mineral-multivitamin complexes for pregnant. It is advisable to carry out iodine prophylaxis throughout the entire period of pregnancy and breastfeeding.

The only contraindication for iodine prophylaxis is pathological hyperthyroidism (Graves' disease). The presence of the patient euthyroid goiter is not a contraindication for pregnancy planning. The exception is extremely rare cases of giant goiter with squeezing phenomena. The main condition for pregnancy planning is the reliable maintenance of euthyroidism, which, if necessary, can be provided by prescribing L-thyroxine("Eutiroks"). Treatment of nodular goiter outside of pregnancy usually has two goals: reducing the size of the nodule and eliminating clinical symptoms in the presence of hyperfunction of the gland. However, during pregnancy there is no need to achieve a radical reduction in goiter. At a minimum, this is due to the fact that the gestational age is limited and it is difficult to achieve a significant decrease in the volume of the thyroid gland in such a short period of time. In addition, even with sufficient intake of iodine during pregnancy, there is some increase in the volume of the thyroid gland. Before starting treatment, patients with nodules larger than 1 cm in diameter undergo an aspiration biopsy of the node.

If, on the basis of a cytological examination, a follicular adenoma of the thyroid gland is diagnosed or there is a suspicion of a malignant neoplasm, surgical treatment is indicated. Conservative treatment is possible only if a nodular colloid goiter is detected, not exceeding 3 cm in diameter. Most often, it is precisely such nodular formations that are detected. Nodal development colloid goiter, as well as diffuse euthyroid goiter, is largely associated with chronic iodine deficiency in the body. Before starting treatment, it is necessary to hormonal study. Treatment of euthyroid goiter includes the use of three therapy options: monotherapy with iodine preparations; monotherapy with L-thyroxine preparations; combined therapy with iodine and L-thyroxine preparations. Treatment is carried out strictly individually under the supervision of a physician. Therapy for euthyroid goiter is carried out for at least 6 months, followed by a follow-up examination and assessment of thyroid function.

Nodular goiter and pregnancy

Prevalence of thyroid nodules among pregnant women is 4%. In the vast majority of cases, a nodular colloid proliferating goiter is detected, which is not a tumor disease of the thyroid gland and, as a rule, does not require surgical treatment. This disease is not a contraindication for pregnancy planning if the nodes do not exceed 4 cm in diameter and are not accompanied by compression syndrome. If a colloid proliferating goiter is first detected in a pregnant woman and its size reaches 4 cm, but does not cause compression of the trachea, then surgical treatment is postponed to the postpartum period.

If a nodule exceeding 1 cm in diameter is detected, it is indicated to carry out aspiration biopsy. Ultrasound control significantly increases the information content of the biopsy. Against the background of pregnancy, the risk of an increase in the size of nodular and multinodular colloid goiter is not great. Since in the vast majority of cases the thyroid function in this pathology is not impaired, patients during pregnancy are shown to carry out individual iodine prophylaxis with physiological doses of iodine. In any case, monitoring of thyroid function is indicated with the determination of the level of TSH and free T4 in each trimester of pregnancy.

Hypothyroidism and pregnancy

Hypothyroidism is a condition caused by a decrease in thyroid function and is characterized by a reduced content of thyroid hormones in the blood serum. Conditions that are characterized by a decrease in the secretion of thyroid hormones, regardless of the specific cause that caused the decrease in its functional activity, are usually called primary hypothyroidism. Among the causes of primary hypothyroidism are: abnormal development of the thyroid gland; iodine deficiency diseases; thyroiditis; thyroidectomy; radioactive iodine therapy and thyroid irradiation; congenital hypothyroidism; prolonged intake of excess iodine; thyroid tumors. Prevalence of hypothyroidism among pregnant women is 2% .

Clinically, hypothyroidism is manifested by such signs as general weakness, decreased performance, convulsive muscle contractions, joint pain, drowsiness, depression, forgetfulness, decreased attention and intelligence, weight gain, decreased heart rate and decreased respiratory rate, dryness skin, hair loss, rough voice, nausea, constipation, amenorrhea and swelling of the skin. With hypothyroidism, all processes in the body slow down. In conditions lack of thyroid hormones energy is produced with less intensity, which leads to constant chilliness and a decrease in body temperature.

Another manifestation of hypothyroidism may be a tendency to frequent infections. Hypothyroidism of a pregnant woman is most dangerous for the development of the fetus and, first of all, for the development of its central nervous system. Most sensitive method The diagnosis of hypothyroidism is the determination of the level of TSH, an elevated level of which indicates a reduced activity of the thyroid gland, and vice versa, a low level of TSH indicates thyrotoxicosis. Thus, the feedback principle is observed between the levels of thyroid hormones and TSH: with a decrease in the levels of thyroid hormones, the level of TSH increases, and vice versa, with an increase in the levels of T4 and T3, the level of TSH decreases. However, when interpreting the data obtained, it must be remembered that low TSH levels can also be observed during pregnancy, pituitary pathology, and other diseases. Normal values levels of thyroid hormones differ depending on the method of conducting the study, however, in most laboratories they are in the range for T4 - 50-160 nmol / l, for T3 - 1-2.9 nmol / l, for TSH - 0.5 -5.5 mIU / l.

Compensated hypothyroidism is not a contraindication for pregnancy planning. The only treatment for hypothyroidism is thyroid hormone replacement therapy. For this purpose, L-thyroxine is used. Treatment and dose adjustment of the drug is carried out under the strict supervision of a physician. Control of the adequacy of therapy is assessed by the level of TSH and free T4, which must be examined every 8-10 weeks. The goal of therapy is to maintain a low-normal TSH level and a high-normal free T4 level.

Autoimmune thyroiditis and pregnancy

autoimmune thyroiditis ( Hashimoto's thyroiditis) is the main cause of spontaneous hypothyroidism. Autoimmune diseases occur when there is a failure immune system recognize tissues of one's own body from "foreign" ones, while autoantibodies to thyroid tissues are formed in the body.

At autoimmune thyroiditis(AIT), when the thyroid gland is affected by an autoimmune process, its additional physiological stimulation does not lead to an increase in the production of thyroid hormones, which is necessary for adequate development of the fetus in the first half of pregnancy. Moreover, hyperstimulation of the altered thyroid gland can lead to the manifestation of hypothyroidism during pregnancy. However, not every increase in the level of AT-TPO indicates AIT. Diagnostic criteria, in identifying a combination of which it is advisable for a pregnant woman to prescribe therapy with L-thyroxine, are: an increase in the level of AT-TPO; an increase in the level of TSH in early pregnancy more than 2 mU / l; an increase in the volume of the thyroid gland more than 18 ml according to ultrasound.

For diagnosis, blood tests for the level of TSH, thyroid hormones, antibodies to the thyroid gland are of fundamental importance. Since the carriage of Ab-TPO has no clinical manifestations, it is necessary to diagnose this pathology before 12 weeks of pregnancy. If an elevated level of AT-TPO is detected without other signs of AIT, a dynamic assessment of thyroid function during pregnancy in each trimester is necessary.

Treatment with L-thyroxine is prescribed depending on the level of TSH. It was noted that in women with elevated levels of Ab-TPO, even without thyroid dysfunction, increased risk spontaneous interruption early pregnancy .

thyrotoxicosis and pregnancy

Thyrotoxicosis syndrome is a collective concept that includes conditions that occur with clinical picture caused by an excess of thyroid hormones in the blood. Sometimes the term is used to refer to this condition. "hyperthyroidism". Currently known diseases, accompanied by the clinical picture of thyrotoxicosis, are divided into two groups.

• Group 1 - thyrotoxicosis, combined with hyperthyroidism: thyroxic adenoma; multinodular toxic goiter; thyrotropinoma; thyroid cancer; hyperthyroid phase of autoimmune thyroiditis; diffuse toxic goiter.
• group 2 - thyrotoxicosis without hyperthyroidism: subacute thyroiditis; postpartum and painless thyroiditis; radiation thyroiditis; thyroiditis caused by taking amiodarone or α-interferon.

Pathological thyrotoxicosis during pregnancy develops relatively rarely. Its prevalence is 1-2 cases per 1000 pregnancies. Almost all cases of hyperthyroidism in pregnant women are associated with diffuse toxic goiter ( Graves' disease). This pathology is a systemic autoimmune disease that develops as a result of the production of antibodies to the TSH receptor, clinically manifested by an enlarged thyroid gland with the development of thyrotoxicosis syndrome in combination with extrathyroid pathology.

Graves' disease is not a contraindication for pregnancy prolongation. In women with moderate and severe disease, infertility develops in almost 90% of cases. Diagnosis of Graves' disease during pregnancy is based on a set of clinical data and the results of laboratory and instrumental studies. One of the first signs of thyrotoxicosis during pregnancy is often vomiting of pregnant women. At the same time, the diagnosis of thyrotoxicosis can be difficult, since pregnancy is often complicated by vomiting in the early stages without pathology of the thyroid gland.

The characteristic symptoms of thyrotoxicosis - sweating, feeling hot, palpitations, nervousness, an enlarged thyroid gland - are also often found in normal pregnancies. However, ocular symptoms specific to Graves' disease may be a clue to the diagnosis, but blood tests with thyroid hormone and TSH levels are required to accurately determine the presence of the disease. Long-term thyrotoxicosis is dangerous by the development miscarriage, congenital deformities in a child.

Nevertheless, with correct and timely treatment with thyreostatic drugs, the risk of these complications is not higher than in healthy women. With Graves' disease first diagnosed during pregnancy, all patients are shown conservative treatment. Thyreostatics intolerance is currently considered as the only indication for surgical treatment during pregnancy. Immediately after the operation, pregnant women are prescribed levothyroxine at a dose of 2.3 μg per kg of body weight. With untreated and uncontrolled diffuse toxic goiter, there is a high probability of spontaneous abortion.

During the first trimester of pregnancy, the use of any drugs is highly undesirable due to their possible teratogenic effects. Therefore, with thyrotoxicosis mild degree antithyroid drugs may not be prescribed. Moreover, pregnancy itself has a positive effect on the course of diffuse toxic goiter, which manifests itself in the need to reduce the dose or even stop antithyroid drugs in the third trimester.

Standard treatment is carried out in tablets thyreostatic drugs: imidazole derivatives (thiamazole, mercazolil, metizol) or propylthiouracil (propicil), the latter being the drug of choice during pregnancy, as it crosses the placenta to a lesser extent and reaches the fetus. Treatment is carried out under the supervision of a physician with an individual selection of the dose of the drug. The main goal of thyrostatic therapy during pregnancy is to maintain the level of free T4 at the upper limit of normal (21 pmol / l). If there are indications thyroid surgery can be carried out during pregnancy, but is currently prescribed to patients only when conservative treatment is not possible. The operation is safe in the second trimester of pregnancy (between 12 and 26 weeks).

Thyroid tumors

Tumors of the thyroid gland according to histological features are divided into benign (follicular and papillary adenoma, teratoma) and malignant. Frequency thyroid cancer is 36 per 1 million population per year and is 2 times more common in women.

Very often, thyroid cancer is a solitary painless nodule, which is regarded as an adenoma or nodular goiter. However, this formation tends to grow rapidly, acquires a dense texture and causes a feeling of pressure in the thyroid gland. The functional state of the thyroid gland, as a rule, remains within the normal range, and only with a significant size of the tumor can the phenomena of hypothyroidism and, much less often, moderate thyrotoxicosis develop.

Almost the only indication for surgical treatment when a nodular formation of the thyroid gland is detected in a pregnant woman is the detection of cancer according to the cytological examination of the material obtained as a result of needle biopsy. The optimal time for surgical treatment is the second trimester of pregnancy. After thyroidectomy the patient is immediately prescribed replacement therapy levothyroxine at a dose of 2.3 mcg/kg of body weight.

Patients with a history of thyroid cancer may plan pregnancy if: at least a year after treatment with I-131, there is no negative trend according to periodic determination of thyroglobulin levels; have received treatment for high-grade thyroid cancer in the past; suppressive therapy is carried out (taking levothyroxine at a dose of 2.5 μg per kg of body weight). Women who plan to become pregnant continue to receive levothyroxine at the same dose, since it is close to the need for levothyroxine in a pregnant woman with hypothyroidism.

Women who have received treatment for undifferentiated and medullary thyroid cancer are currently contraindicated in pregnancy planning. The exception is patients who underwent prophylactic thyroidectomy for various variants of familial forms of medullary thyroid cancer.

After an appropriate examination and treatment under the supervision of an endocrinologist, the following categories of patients with thyroid pathology can plan pregnancy: women with compensated primary hypothyroidism that developed as a result of autoimmune thyroiditis or surgical treatment of non-tumor thyroid diseases; patients with various forms euthyroid goiter (nodular, multinodular, mixed), when there are no direct indications for surgical treatment (significant nodular goiter compression syndrome); women with carriage of antibodies to the thyroid gland in the absence of a violation of its function. In these patients during pregnancy, it is necessary to conduct a dynamic assessment of thyroid function with the determination of the level of TSH and free T4 in each trimester of pregnancy. In addition, pregnant women with goiter should undergo dynamic ultrasound.

Women with uncompensated hypothyroidism as a result of autoimmune thyroiditis or after surgical treatment of non-tumor thyroid pathology can plan pregnancy after achieving euthyroidism on the background of levothyroxine replacement therapy. In patients with thyrotoxicosis, after reaching a stable remission, pregnancy can be planned after 2 years. If therapy was radioactive iodine- Pregnancy should be postponed for 1 year. At surgical treatment Graves' disease, pregnancy can be planned in the near future against the background of hormone replacement therapy. Therefore, it is important to make an appointment with an endocrinologist as early as possible in order to detect a particular disease!

Thyroid during pregnancy: hypothyroidism, hyperthyroidism. How does the thyroid gland affect pregnancy?

During pregnancy, changes occur throughout the body, but one of the most important organs during pregnancy is the thyroid gland, of course, after the reproductive system. Although their functions are closely related and proper development baby, his mental capacity depend on the proper functioning of the pregnant thyroid gland, normal hormonal levels.

The topic is important and you should familiarize yourself with it so as not to panic, for example, after receiving an ultrasound report or a blood test for thyroid hormones during pregnancy and at the planning stage.

• How does the thyroid gland work
• Regulation of the thyroid gland during pregnancy is normal and in diseases of the thyroid gland
• thyroid ultrasound during pregnancy
• Changes in thyroid hormones during pregnancy
• Why does TSH decrease and is this the norm
• Iodine deficiency during pregnancy: how it affects pregnancy and what to do
• Symptoms of hypothyroidism
• Symptoms of hyperthyroidism
• Who needs to take TSH at the stage of pregnancy planning
• Hypothyroidism and pregnancy
• Features of treatment

How does the thyroid gland work and how is the regulation of its work

If we consider the issue quite simply, then the main task of the thyroid gland is to produce the hormone thyroxine. This hormone acts on all cells of body tissues and acts as a regulator of metabolic processes. Many things happen when the thyroid gland is dysfunctional. pathological changes, which during pregnancy concern not only the woman, but also the fetus.

The thyroid gland is quite small, located superficially on the anterior surface of the neck. It is easy to palpate. Therefore, any changes: enlargement, nodes, areas of dense tissue can be determined by manual examination. Ultrasound is done to clarify the diagnosis. Glandula thyreoidea - has the shape of a butterfly: two wings and an isthmus.

The work of the thyroid gland is regulated by another gland - the pituitary gland through. The work of the pituitary gland, in turn, regulates the hypothalamus. And all these interactions and connections are still influenced by the central nervous system.

Regulation of the thyroid gland

1. Norm option:

If the thyroid gland secretes a sufficient amount of hormones T₃ and T₄, then the pituitary gland determines their concentration as normal and releases that amount of stimulating hormone TSH, which will be enough to maintain a stable level of thyroid hormones. This balance is normal.

1. Hypothyroidism:

If pathological processes have occurred in the body, as a result of which the thyroid gland synthesized less hormones, then the pituitary gland releases more TSH into the blood, thereby stimulating the thyroid gland in terms of hormone synthesis. In some cases, an increased level of TSH is accompanied by an increased concentration of thyroxine (T₄). If this situation can be compensated at this stage, then subclinical hypothyroidism occurs - there are no clinics, complaints and manifestations of the disease, but TSH is elevated, and thyroid hormones are still normal. Normal levels of T₃ and T₄ are maintained only through active stimulation of the thyroid gland by the pituitary gland through TSH.

At a certain point, the reserves of the thyroid gland are depleted, and an increase in TSH and a low level of thyroxine - T₄ are observed in the blood. This will be an insufficient function of the thyroid gland - hypothyroidism.

1. Hyperthyroidism:

In the reverse situation, a high concentration of thyroid hormones leads to a decrease in the production of the stimulant hormone TSH by the pituitary gland. This situation is called hypertoxicosis: TSH decreases and thyroxine rises.

Thyroid hormones during pregnancy

During pregnancy, it is primarily important, because when determining the concentration of only thyroxine (which will be within the normal range), one can falsely conclude that everything is normal with the pregnant woman's body. And at this time, TSH can be increased and the thyroid gland in a pregnant woman will work at the limit of her capabilities, only to support normal level T₃ and T₄.

At the same time, if the TSH level is normal, then the thyroid hormones will also be within the normal range. If TSH is increased or decreased, then T₄ and T₃ are examined.

If a pregnant woman is examined, she is given a referral for the study of TSH and thyroxine - T₄ free. This is done so that a woman is no longer sent to take tests, minimizing psychological stress before taking tests if the level of TSH is outside the normal range (increased or decreased).

There are two indicators of thyroxine: free and bound. The fact is that hormones are not just dissolved in plasma, but are associated with carrier proteins. A large proportion of thyroxin is associated with the carrier. Less than 1% of all thyroxine is in a free state. It is the free hormone that has its effect. Therefore, the free fraction of thyroxine is determined.

Triiodothyronine -T₃ is not routinely determined, only strictly according to indications.

There is another indicator that is prescribed quite often - antibodies to thyroperoxidase (AT-TPO). These are body proteins that are produced as a result of autoimmune processes, their action is directed against the thyroid gland and destroy its tissue. A high titer of antibodies should not be frightening, since the process of destruction is quite long and a decrease in thyroid function may not occur throughout life. An elevated level of AT-TPO is a reason to regularly monitor TSH (1 time in 3 months).

The superficial location of the thyroid gland allows you to examine the organ with your hands. An ultrasound of the thyroid gland during pregnancy can be done, but the study does not make sense without determining the TSH, and examining the endocrinologist. That is ultrasonic method research is assigned to clarify the diagnosis, if the endocrinologist sees an increase or determines the nodes during palpation.

The normal volume of the thyroid gland in women is up to 18 cm³. A node is considered to be a formation whose size exceeds 1 cm in diameter. If such a node is found on ultrasound, then it is advisable to puncture it and make sure that the process is not oncological.

Our country is in an endemic zone: almost everyone has mild and moderate iodine deficiency. Therefore, if thyroid hormones are normal, then nothing is usually done with such nodes.

Changes in thyroid hormones during pregnancy

During pregnancy, TSH levels decrease. The norm for a "non-pregnant" organism is 0.4-4 honey. In pregnant women normal TSH below:

• in the first trimester< 2,5 мЕд;
• in the second and third trimester< 3 мЕд.

Why does thyroid-stimulating hormone decrease during pregnancy?

The hormonal background during pregnancy changes, but it changes not quite the same. There are cases when human chorionic gonadotropin stimulates the thyroid gland very strongly and the TSH level can be less than 0.1 mU. In such a situation, if not, the pregnancy develops normally, there is no severe tachycardia (more than 140 beats per minute), this may be gestational hyperthyroidism, which does not require treatment. But one must always be on the alert for true thyrotoxicosis. If the level of TSH is very low and there are complaints, then you need to take a blood test for antibodies to TSH receptors, it is called AT-r-TSH. If these antibodies are not detected, then the transcendental decrease in TSH is associated with pregnancy, and not with diffuse toxic goiter.

Iodine deficiency during pregnancy

If there is enough iodine in food, then medications in the form of Iodomarin, it is not necessary to prescribe during pregnancy. But living in endemic areas provides for the appointment of iodine supplements at the planning stage and until the end of the third trimester. If a woman, being pregnant, goes to rest on the seashore, then the food that is grown on the coast is already rich in this element. Then the use of iodine tablets is not required. If you live in or go on vacation to a country where a universal salt iodization program has been adopted, then additional prescription of iodine preparations is also not necessary.

If a woman during pregnancy did not take additional iodine tablets and lived on lands with insufficient iodine content in the soil, then it is not necessary that the deficiency can affect the mental abilities of the baby. Most likely, the thyroid gland of a pregnant woman will try to compensate for iodine deficiency, it may increase in size in order to capture more iodine from the blood and provide the necessary amount of hormones for herself and the baby. In rare cases, hypothyroidism may occur.

Foods rich in iodine:

• seaweed;
• all types of marine fish and shellfish;
• squid;
• shrimps.

What you need to know about the thyroid gland during pregnancy

1. The starting point in diagnosing thyroid disease during pregnancy is the level of TSH.
2. Ultrasound of the thyroid gland is performed only according to indications.
3. When prescribing Iodomarin, the daily dose is 200 mcg per day, unless the doctor has prescribed otherwise. The drug should be taken throughout pregnancy and lactation. If you are relaxing at sea, in agreement with the doctor, the drug is temporarily canceled.
4. If L-thyroxine (Eutirox) has been prescribed, no experiments with the dose and frequency of administration can be carried out.

Features of the treatment of thyroid gland during pregnancy

L-thyroxine is taken on an empty stomach, at least 30 minutes before a meal. If you take the drug after breakfast or immediately before eating, the required dose will not fully enter the body. This is the same hormone that the thyroid gland produces. negative impact it does not affect the digestive organs.

The thyroid gland has a huge impact on the functioning of the female reproductive system. Violations of the secretion of thyroid hormones can lead to problems with conception and childbearing, adversely affect the intrauterine development of the fetus.

Is it possible to get pregnant with thyroid diseases, how does this affect the conception of a child? Thyroid hormones are responsible for metabolic processes in the body, the work of the cardiovascular, digestive, nervous and genitourinary systems. If the hormonal background is disturbed, then the menstrual cycle fails, the maturation of the follicle in the ovaries occurs.

Lack of ovulation leads to infertility. Therefore, pregnancy in diseases of the thyroid gland occurs very rarely. If conception does occur, then in most cases spontaneous abortion occurs in the early stages. A great influence of the thyroid gland on conception is observed in autoimmune thyroiditis. Therefore, women are advised to undergo neonatal screening at the stage of family planning. Effective medicines against this disease has not yet been developed.

Thyroxine and triiodothyronine are involved in the formation of the nervous, cardiovascular, reproductive systems and brain of a child. Therefore, any disturbances in the work of the endocrine organ of the mother can cause a lag in the physical and intellectual development of the unborn baby.

The formation of the thyroid gland of the embryo begins at the 5th week of intrauterine development and ends by 3 months. Until this time, the child provides hormones, iodine to the mother's iron, which begins to produce thyroxine 2 times more than usual. This leads to an increase in the volume of gland tissues. This condition is not considered a pathology and disappears after childbirth.

Hypothyroidism in pregnancy

With hypothyroidism, spontaneous abortion can occur in the early stages, miscarriage, fetal fading, it is difficult for a woman to give birth, complications arise after childbirth. Children are born with a mental disorder and physical development.

The state of health of a woman with hypothyroidism worsens, she is worried about:

• general weakness, fatigue;
• increased heart rate, tachycardia, lowering blood pressure;
• violation of the chair;
• chilliness, decrease in body temperature;
• migraine, joint and muscle pain;

• swelling of the body;
• convulsions;
• hair loss, brittle nails;
• dry skin, mucous membranes;
• irritability, frequent mood swings.

Hypothyroidism during pregnancy is quite rare, as women suffering from this disease, long time unable to conceive a child due to irregular menstruation and lack of ovulation.

Thyrotoxicosis during pregnancy

This disease of the thyroid gland in pregnant women develops with increased secretion of thyroid hormones. Almost all cases of pathology are associated with. This is an ailment of an autoimmune nature, which is accompanied by the production of antibodies that stimulate the increased production of thyroxine and triiodothyronine, a decrease in the level of thyroid-stimulating hormone, as a result, diffuse tissue growth occurs.

Autoimmune thyroid pathology and pregnancy can be caused by thyroiditis, toxic adenoma, long-term use of thyroxine, gestational trophic disease.

The main symptoms of thyrotoxicosis include:

• nervousness, irritability;
• sweating, heat intolerance;
• enlargement of the thyroid gland;
• weight loss;
• frequent diarrhea;
• bulging eyes;
• severe toxicosis, indomitable vomiting.

Thyrotoxicosis in some cases is an indication for abortion. With the help of thyreostatics, it is sometimes possible to stabilize the woman's condition and save the fetus. But without timely therapy, miscarriage or the birth of a child with malformations, deformities, and thyroid diseases occurs. During childbirth, a woman may develop a thyrotoxic crisis.

The complexity of therapy lies in the fact that thyreostatics penetrate the placental barrier and can also provoke the development of goiter in a child. Therefore, treatment is prescribed strictly individually. In some cases, a partial resection of the thyroid gland is performed to cause hypothyroidism.

Thyroiditis

Pregnancy and nodular goiter are not dangerous state for woman. In 80% of patients, benign seals are found that do not disrupt the functioning of the endocrine organ and do not interfere with the birth of a healthy child.

goiter treatment

If a woman is diagnosed with a goiter, then a decision is made to conduct therapy. Treatment methods are selected individually for each patient, taking into account the severity and cause of the disease.

To clarify the etiology of the neoplasm, a node is also performed during pregnancy. According to the results of the analyzes, a further treatment regimen is determined. If cancer cells are detected, then surgery is postponed for postpartum period. Urgent surgery is performed only if the goiter during pregnancy compresses the trachea. The best time for therapy is the second trimester.

In other cases, monotherapy, L-thyroxine, or their complex combination is prescribed.

Is it possible to get pregnant without a thyroid gland

Pregnancy after is possible. After the operation, women take drugs that replace thyroid hormones. After surgery, at least one year of rehabilitation is required to recover normal operation organism. Then you can plan a pregnancy.

If the absence of the thyroid gland is caused by a malignant tumor. Then after the operation, chemotherapy is carried out, supporting treatment. The woman's body weakens, and conception occurs only in isolated cases.

Pregnancy without a thyroid gland should proceed under the supervision of a doctor and under constant control blood hormone levels. The gynecologist and endocrinologist prescribe the necessary dosage of drugs and monitor the intrauterine development of the fetus.

Thyroid diagnosis during pregnancy

At the stage of family planning, women undergo a complete examination. Diagnostic ultrasound of the thyroid gland during pregnancy is indicated for existing diseases of this organ, the presence of pathology in the history of the next of kin, and if there are characteristic symptoms ailments.

According to the results of ultrasound examination, it is possible to assess the volume, structure of the organ, the presence of nodes, and the inflammatory process. Normally, the thyroid gland is slightly enlarged, but should not exceed 18 cm³ with a body weight of 50–60 kg. When seals are detected, a puncture biopsy is indicated. This analysis helps determine the nature of the node.

Thyroid hormones during pregnancy should be within the following limits:

• in the first trimester - 0.1-0.4 mU / ml;
• The norm of TSH in the second trimester is 0.3–2.6 mU / ml;
• In the third trimester, the level of TSH can rise to 0.4–3.5 mU / ml;
• The presence of antibodies to TPO indicates autoimmune thyroiditis.

Minor deviations from the norm are not an alarming symptom because every woman's body is different. A cause for concern is considered to be a significant excess or decrease in the limit of indicators.

Tests for thyroid hormones are taken by women with signs of disruption of the endocrine organ, if there is a history of diagnosed diseases and with long-term treatment of infertility.

Women with thyroid disease have a low chance of conceiving a child, an increased risk of early termination of pregnancy and difficulties during pregnancy and childbirth. Violation of the hormonal background negatively affects the intrauterine development of the fetus, can cause congenital pathologies.

Bibliography

1. Obstetrics and gynecology: diagnosis and treatment. Tutorial. In 2 volumes. DeCherni A.Kh., Nathan L. 2009 Publisher: MEDpress-inform
2. Emergency conditions in obstetrics and gynecology: diagnosis and treatment. Pearlman M., Tintinalli J. 2008 Publisher: Binom. Knowledge Lab.
3. Medicines used in obstetrics and gynecology / edited by V.N. Serov, G.T. Dry / 2010, ed. 3, corrected and supplemented - M.: GEOTAR-Media.
4. Obstetric tactics for breech presentation, Strizhakov A.N., Ignatko I.V., M.: Dynasty, 2009.
5. Emergency care for extragenital pathology in pregnant women. 2008, 2nd edition, revised and supplemented, Moscow, Triada-X.
6. Obstetrics: a course of lectures. UMO vulture medical education. Strizhakov A.N., Davydov A.I., Budanov P.V., Baev O.R. 2009 Publisher: Geotar-Media.

Every third woman of reproductive age has thyroid disease. As practice shows, they require special supervision by specialists. What diseases of the thyroid gland can adversely affect the bearing of a baby? What should women do to bear a healthy child without harm to their health?

Thyroid functions

The thyroid gland is not the main organ in the human body, but at the same time, any failure of it can lead to serious consequences. The thyroid gland is a small organ, but very important. The importance lies in the fact that the thyroid gland produces such a hormone, which is necessary for the proper functioning of all organs, it affects metabolic processes, general state and mental development.

Iodine is a unique element, without which the thyroid gland will not be able to work properly, and it will not work to bear the baby. It is he who helps to synthesize hormones that the thyroid gland produces: thyroxine (T4) and triiodothyronine (T3). It promotes the correct exchange of all nutrients that enter the body. Hormones are very important for women in everyday life and during conception and fetal development. They are responsible for intrauterine development all systems of the fetal body, including the musculoskeletal system.

Iodine is an important element not only for the functioning of the thyroid gland, but also for bearing a baby.

That is why every woman should be examined by an endocrinologist before becoming pregnant. If the pathology of the thyroid gland is exposed after conception, you must strictly follow all the doctor's recommendations.

Thyroid gland during conception planning

When planning to conceive right job thyroid is very important. Her condition and timely production of hormones determines the success of conception. Not only the physical, but also the mental development of such a person depends on how high-quality hormones the body produces. long-awaited baby. Every woman during pregnancy planning should go around the doctors and make sure that everything is in order with her health. A blood test will help determine the quantity and quality of thyroid hormones, and an ultrasound scan will help determine how well the organ is working.

During the planning of conception, attention is paid to the level of thyroid-stimulating hormone, its amount should be no more than 2.5 μIU / ml. If the level exceeds the norm, then this is the first signal that requires serious specialist intervention. The doctor will prescribe treatment to normalize the production of the hormone, most often the therapy is associated with dietary nutrition, it is recommended to consume foods rich in iodine. When the tests are normal, you can plan a pregnancy.

What pathologies can adversely affect the bearing of a baby?

The thyroid gland and pregnancy are interconnected, all diseases of the organ can adversely affect not only the conception itself, but also the bearing of the baby. Which of the pathologies most affects pregnancy? Which ? Pathologies can be of a different nature:

1. Congenital diseases: underdeveloped thyroid gland, absence of an organ and incorrect location.
2. Endemic and sporadic goiter - pathology manifests itself due to low levels of iodine in the body.
3. Thyroiditis - inflammatory processes in the body.
4. Hypothyroidism - this disease is associated with a decrease in organ function.
5. Injuries and neoplasms.

Women need to be tested before having a baby.

If a woman had no health problems before conception, then during pregnancy, thyroid pathologies will not bother her. The only thing that can happen is its slight increase, but this state of the body is considered the norm when carrying a baby, frost should cause anxiety in the future mother. If you have any concerns, you should consult with an endocrinologist.

Thyroid enlarged during pregnancy

Enlargement of the organ during pregnancy is the norm. The organ becomes larger due to the fact that it starts to work faster, because during pregnancy all the organs of a woman must work for two and, as a result, more hormones are produced. This is true for those women who had thyroid pathologies before conception, but diseases can appear after a woman has conceived and cause an increase in the organ. Among them:

• Hypothyroidism. It appears due to malfunctions in the immune system and a woman learns about it only when the pathology becomes chronic. It is difficult to determine the pathology, since the symptoms are very similar to the signs of pregnancy. That is why if there is a suspicion of this particular disease, then it is recommended to undergo a laboratory test, and the amount of hormones is determined from it.
• thyrotoxicosis. This pathology is due to increased activity organ, and this in turn leads to the fact that there is an increase in the thyroid gland. In pregnant women this pathology- it is a rarity. The main symptom of the disease is severe vomiting and enlargement of the eyeballs. If a woman conceived a baby and she already had this pathology, then high risk not only for the baby, but also for the patient herself.

How does an enlarged thyroid gland manifest itself during pregnancy?

An increase in the organ during pregnancy is considered the norm. At the same time, the woman does not experience any discomfort. Each woman can independently determine that the thyroid gland has increased:

• feeling that it tickles in the throat,;
• an enlarged organ is visible, the neck has thickened, pain when swallowing, shortness of breath appears;
• the contours of the neck change and when swallowing, you can see the lobes of the thyroid gland;
• with a strong increase, the voice disappears, there are difficulties with normal breathing and swallowing.

If the pathology manifested itself after conception, then strict control over the development of the fetus is necessary.

If such symptoms appear, the patient needs to urgently seek help from a specialist who will conduct a thorough examination and make an accurate diagnosis. After that, the doctor prescribes therapeutic therapy, which will remove all the symptoms and enable the woman to bear a healthy baby without harm to her health.

Medical therapy

Pregnant patients in the treatment of thyroid gland are recommended complex therapy aimed at eliminating all symptoms, pain and discomfort. When carrying a baby, therapy will consist in taking hormonal drugs and drugs, which contain a high concentration of iodine. This will allow the baby to develop in accordance with the deadline.

AT short time and most importantly, Monastic Tea will help to effectively cure the thyroid gland. This product contains only natural ingredients, which have a complex effect on the focus of the disease, perfectly relieve inflammation and normalize the production of vital hormones. As a result, all metabolic processes in the body will work correctly. Thanks to unique composition"Monastic tea" it is completely safe for health and very pleasant to the taste.

At the very important point life of each woman therapy depends on the severity of the disease and its impact on the fetus. If a benign tumor is detected, iodine therapy is prescribed. With a malignant tumor, the use of hormonal drugs does not affect the fetus in any way. Therapy is prescribed by a doctor, carried out under his strict supervision.

The thyroid gland and pregnancy are closely related, so if the first discomfort appears, it is better to undergo an examination and find out how much the disease can harm the unborn baby. Without the qualified help of an endocrinologist and regular examinations, a woman with serious thyroid lesions may not be able to bear a baby or give birth to a child with serious disorders of the nervous system or with mental retardation.