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Thyroid Disorders in Pregnancy

Overt and subclinical thyroid dysfunction affect fertility, pregnancy course, and offspring neurodevelopment and require pregnancy-specific management.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Thyroid Disorders in Pregnancy?

Pregnancy increases thyroid hormone demand by 30–50% because of higher thyroxine-binding globulin and placental deiodinase activity, and because of the transient stimulation of the thyroid by human chorionic gonadotropin in early gestation.

Common disorders include overt and subclinical hypothyroidism, overt hyperthyroidism (most often due to Graves disease), gestational transient thyrotoxicosis, and autoimmune thyroiditis with positive anti-TPO antibodies.

Interpretation requires trimester-specific TSH and free T4 reference ranges, as recommended by ATA and ETA guidelines.

Untreated disease is associated with miscarriage, preterm birth, preeclampsia, placental abruption, low birth weight, and in severe cases impaired neurodevelopment.

Symptoms

Fatigue, cold intolerance, constipation, and weight gain in hypothyroidism
Tachycardia, heat intolerance, tremor, and weight loss in hyperthyroidism
Palpable goitre, neck discomfort, or hoarseness
Hyperemesis and dehydration with gestational transient thyrotoxicosis
Dry skin, hair loss, and cognitive slowing in chronic hypothyroidism
Exophthalmos or pretibial oedema in Graves disease

Risk Factors

Pre-existing thyroid disease or prior thyroid surgery or radioiodine
Positive anti-thyroid peroxidase or anti-thyroglobulin antibodies
Family history of autoimmune thyroid disease
Iodine deficiency or excess iodine intake
Type 1 diabetes and other autoimmune conditions
Infertility treatment or recurrent miscarriage

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Known thyroid disease before or at the start of pregnancy for early TSH evaluation and dose adjustment
  • Symptoms such as palpitations, marked fatigue, severe nausea, or neck swelling during pregnancy
  • Abnormal thyroid function tests detected during routine antenatal screening

Treatment Methods

01
Measurement of TSH, free T4, and TPO antibodies with trimester-specific interpretation
02
Levothyroxine for overt and high-risk subclinical hypothyroidism, targeting TSH within trimester-specific limits
03
Propylthiouracil in the first trimester and methimazole thereafter for Graves disease, using the lowest effective dose
04
Beta-blockers for symptomatic control of tachycardia in hyperthyroidism when indicated
05
Fetal monitoring with ultrasound for growth, goitre, and heart rate when TRAb titres are elevated
06
Postpartum thyroid reassessment at 6–12 weeks to detect postpartum thyroiditis and plan long-term follow-up

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.