Thyroid and Pregnancy

Thyroid and Pregnancy. In pregnancy must take into account two factors, the thyroid of the mother and the child’s thyroid. Everyone has their own personality and requires its own attention.

Thyroid of the child.

In relation to the thyroid of children have to remember the “rule of three”

After three weeks of conception begins to form the outline of what must be the child’s thyroid, the woman at this time often do not know yet who is pregnant, from the third month of conception, the fetal thyroid is already able to accumulate iodine, operate and produce its own hormones, three weeks after birth the newborn baby has used hormones that could come from their mother, have exhausted their deposits and began to work connected with the pituitary gland.

During pregnancy, the first embryo and fetus after they are well protected. They have two possibilities of using thyroid hormones: those that he makes and those of his mother passing the placenta. If your mother has a severe hypothyroidism, the child uses the hormones it produces, if the child has a thyroid agenesis, or congenital lack of thyroid, also has no problem, use the hormones that supplies your mother. In both cases the child is born perfectly normal in their development.

The thyroid problem during pregnancy occurs when there is a lack of iodine to produce thyroid hormones. In these circumstances it works well or the thyroid of the mother or the fetus, and then there are problems.

Mother’s thyroid. Changes induced by pregnancy.

Although she is a woman you absolutely normal pregnancy for thyroid is a major impact. But do not worry you are prepared for that and more. That gender equality is nonsense, women are physiologically better equipped than men.

Pregnancy is accompanied by the influence of a number of factors specific to this condition which together represent a major stimulus of the thyroid of the pregnant woman.

The first factor, which influences all in the first quarter, thyroid stimulating hormone produced in the placenta, chorionic gonadotropin Lets talk a little about it. Production begins immediately with the design, the 2 to 3 days. It is this hormone that is detected in blood or urine and is the basis of pregnancy tests. However, chorionic gonadotropin is very similar to TSH and may stimulate the thyroid. Approximately 18% of pregnant women during the first quarter a slight stimulation of the thyroid that goes unnoticed among the other pregnant women feel discomfort. There may be a slight elevation of T4 and a suppression of TSH in the first quarter is normal and should not be confused with hyperthyroidism. In the second and third quarter down chorionic gonadotropin levels and the picture tends to subside.

Well, if there is an increase of thyroid hormones in blood and inhibition of TSH, a gynecologist and endocrinologist have the right to think there may be a hyperfunctional status. But there are data that can help make a difference: first normal antithyroid antibodies and especially the ultrasound is normal in this false hyperthyroidism might be called the first trimester of pregnancy. In hyperthyroidism there is an increase authentic vascularization in the thyroid gland appears as a low echogenicity, the study eco-color doppler is very apparent increased vascularity, in the false hyperthyroidism thyroid ultrasound is absolutely normal.

In the second and third quarter are also factors that alter thyroid function, but are otherwise. Although not entirely clear, this problem could be implicated themselves female hormones, primarily estrogen. We discussed in the opening chapters of Physiology which circulating thyroid hormones in the blood largely bound to a protein called TBG (thyroxine binding globulin Bindig Globulin or thyroxine or Conveyor), well in pregnancy figures TBG soar, between 16-20 weeks of gestation the number of TBG in blood are doubled. In these circumstances the levels of T4 and T3 in the blood are altered and can give the false impression of a functional impairment. But this issue is resolved, because the T4-Free is unchanged and remains normal. Simplify and summarize:

In pregnant by changes in hormonal status can be seen discrete changes in the levels of T4, T3 and TSH. -Free T4 is not altered. Conventional ultrasound and echo-color doppler (vascularization), are normal.

For the reasons we have cited above the thyroid of the mother during pregnancy is forced. It is estimated that the thyroid of the pregnant woman produces between 30% and 50% more than in normal thyroxine. To maintain the level of T4-Free stabilized blood must increase its production rate and also the mother to the fetus transfer a portion of their hormones, not much, but enough to maintain normal growth if the fetus had problems with your thyroid .

In pregnancy the mother’s thyroid can grow a little. But perhaps not always in a 10-15% of cases. This confirmed by ultrasound. But it’s a very discreet and you can later return to their normal size.

Regulation of thyroid function in pregnant women with iodine deficiency.

Under normal conditions, as we previously indicated, the moderate exertion requesting the thyroid is fine, but if there is a deficiency in iodine, the situation is different. The thyroid of the mother is insufficient to produce the quantity of hormone needed, because it has enough iodine without material may not be can not build a house. The mother’s TSH is elevated and the thyroid of the mother increases. The child feels the same and also may be born with a small goiter, apart from the problems of development that could have had.

The iodine requirements of a normal woman is 150 micrograms per day, pregnant women need 200 micrograms. Iodine supplementation in the form of single dose “shock” in the first two months of pregnancy or compounds included in multivitamin and polimineral type of currently used can solve this problem.

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It’s hard to bare and more likely stand with it as you take it all throughout your life and your baby too is greatly affected with the complications.
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This is why fetoscopy is performed when baby is fully grown inside the womb. To check for any complications a fetoscope is used with the aid of ultra sound so it can be detected in an early stage and prepare the parents for necessary medications.

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