Thyroid Problems (cont.)
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Hypothyroidism in Pregnancy
Newly diagnosed hypothyroidism in pregnancy is rare because most women with untreated hypothyroidism do not ovulate or produce mature eggs in a regular manner, which makes it difficult for them to conceive.
It is a difficult new diagnosis to make based on clinical observation. The signs and symptoms of hypothyroidism (fatigue, poor attention span, weight gain, numbness, and tingling of the hands or feet) are also prominent symptoms of a normal pregnancy.
Undiagnosed hypothyroidism during pregnancy increases the chance of stillbirth or growth retardation of the fetus. It also increases the chance that the mother may experience complications of pregnancy such as anemia, eclampsia, and placental abruption.
Probably the largest group of women who will have hypothyroidism during pregnancy are those who are currently on thyroid hormone replacement. The ideal thyroxine replacement dose (for example, levothyroxine [Synthroid, Levoxyl, Levothroid, Unithroid]) may rise by 25% to 50% during pregnancy. It is important to have regular checks of T4 and TSH blood levels as soon as pregnancy is confirmed; and frequently through the first 20 weeks of pregnancy to make sure the woman is taking the correct medication dose. It is recommended that the levothyroxine dose be adjusted to keep the TSH level < 2.5 mIU/L during the first trimester of pregnancy and < 3 mIU/L during the last two trimesters of pregnancy. Usually the increase in thyroid hormone needed during pregnancy disappears after the delivery of the baby and the pre-pregnancy dose of levothyroxine can be resumed immediately post-partum.
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