<i>Prevent hypothyroidism and its consequences during pregnancy</i>
Hypothyroidism is a disease caused by insufficient production of thyroid hormone secreted from thyroid gland (an endocrine gland in the neck; also known as Adam's apple in men). It is particularly common in women of child bearing age. It is estimated that 2.5% of all pregnant women have some degree of hypothyroidism that may complicate the pregnancy and affect the baby. For years, physicians have known a link between mothers with hypothyroidism during pregnancy and developmental delay in their children after birth. This was particularly seen in mothers who came from iodine deficient areas. Iodine is necessary to produce thyroid hormone and is now a common component of the salt in our foods. It was also observed in mothers with autoimmune thyroid disease, such as Hashimoto's Thyroiditis. In some conditions like iodine deficiency, genetic defect, the thyroid may be inhibited, damaged or destroyed and little thyroid hormone is produced. As a result of decreased production by the thyroid gland, patients often notice fatigue, lethargy and weight gain. Constipation is common and many patients with hypothyroidism report feeling excessively cold. Uncontrolled hypo-thyroidism in pregnant women can have long-term effects on the children of these mothers. The children may suffer from developmental delay, intellectual disability. These effects may occur even if the hypothyroidism is mild and the woman does not exhibit any symptoms. Pregnant women with hypothyroidism can have severe adverse effect in early pregnancy if untreated. Because the baby's thyroid gland does not develop before 12 weeks of gestation and entirely depend on mothers hormone. So some experts recommend that all women who are planning a pregnancy should be considered for screening of thyroid disease. However, treatment for both baby with hypo-thyroidism and the pregnant mother is available in the country. The goal of hypothyroidism in pregnancy is to maintain a thyroid hormone level within high normal range. Pregnant women as well as their newborn babies should be screened for the disease and should seek adequate treatment without any undue prolongation. Here are some of experts' advice that need to be focused to prevent and detect the disease at early stage: • All pregnant women with a goiter (enlarged thyroid gland), high blood levels of thyroid antibodies, a family history of thyroid disease, or symptoms of hypo-thyroidism should be tested for hypothyroidism. • In women who have borderline or sub-clinical hypothyroidism (for example, not in the laboratory range for true hypothyroidism, but within the low normal range) and who also have positive antibodies (which may indicate an ongoing autoimmune thyroid destruction), therapy with low dose thyroid hormone at the onset of pregnancy may be beneficial. • Women who are on thyroid hormone replacement before pregnancy should also be tested to make certain that their levels are appropriate. • Dosing is dynamic during pregnancy and should be closely monitored by regular blood testing. As the pregnancy progresses, many women require higher doses of hormone replacement. However, the management of each woman's situation is considered individually after consultation with her physician. We all have to make sure that no woman with hypothyroidism is left untreated before conception. The benefits of treatment extend not only to pregnant women with hypo-thyroidism, but also to their children. The write-up is compiled by Dr Shahjada Selim, Shaheed Suhrawardi Medical college Hospital, Dhaka.
For all latest news, follow The Daily Star's Google News channel.
Comments