Times of India
15 January 2010
By Umesh Isalkar
Pune, India

Miscarriage, pre–mature delivery and pre–eclampsia (pregnancy induced high blood pressure) are among the prominent complications seen among expectant mothers who are low in a hormone produced by the thyroid gland.

Experts say that 15 per cent of city’s women population suffer from some kind of thyroid disorders. Of this, hypothyroidism (low secretion of hormone thyroxine) constitutes 10 per cent of the cases. The normal range of hormone thyroxine is .5 to 2.5 TSH (thyroid stimulating harmone) in adult women.

“It is important that hyperthyroidism in pregnant women be controlled since the risks of miscarriage, pre–mature delivery and pre–eclampsia are high among them,” said gynaecologist Sanjay Gupte, president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI). Fortunately, there are effective treatments available to treat hypothyroidism, he added.

Agreeing to it, endocrinologist Uday Phadke said, “Thyroid related disorders are of varying types like low secretion, high secretion of hormone produced by thyroid gland, nodules etc. The percentage of these nodules having cancerous malignancy is five per cent. Among these disorders, hypothyroidism – low secretion of the hormone – is seen among 10 per cent of women.”

Symptoms in Women

• Fatigue
• Hair Loss
• Dry skin
• Cold Intolerance
• Muscle ache, stiffness and pain
• Excessive weight
• Goitre may or may not be present

Complications that May Occur in Hypothyroid Pregnant Women

• Anaemia
• Pregnancy induced high blood pressure
• Placental Abruption
• Preterm Delivery
• Excessive bleeding during or after delivery

(Source: Pune Obsterics and Gynaecological Society)

Thyroid gland is present in the front part of the neck and secretes important hormones. Its function, in very general terms, is to stimulate body metabolism. Disturbances of thyroid function are much more common in women then men. The disturbances can be in the form of overactivity or under–activity of the gland, said Phadke.

Gynaecologist Charuchandra Joshi, consultant, high risk pregnancy, at Sahyadri Hospital, said, “Important causes of hypothyroidism are – dietary deficiency of iodine and autoimmune disorders, viral infection and surgical removal of thyroid gland. Mild hypothyroid pregnant women behave very much similar to normal pregnant women. Some adjustments in the thyroxin dosage may be all that is required.”

Those with severe hypothyroidism can face several problems during pregnancy. They are also more prone to certain complications like anemia, high blood pressure, severe and lifethreatening bleeding during pregnancy or after delivery, said Joshi. In pregnancy, due to profound changes in the hormones and metabolic demands, the thyroid gland enlarges and it is visible in the form of swelling in the front part of the neck. It is called ‘physiological goitre’. It disappears on its own, about 6 weeks after delivery, added Joshi.

Explaining symptoms manifested by the thyroid disorders, Phadke said, “Women with low level of thyroid hormone experience fatigue, sluggishness (muscular as well as mental), excessive weight gain etc.”

“Because some of the symptoms of hypothyroidism such as tiredness and weight gain are already quite common among pregnant women, it is often overlooked and not considered as a possible cause of these symptoms. Blood tests, particularly measuring the TSH, can determine whether a pregnant woman’s problems are due to hypothyroidism or not,” said infertility expert Sanjeev Khurd, president of Pune Obsterics and Gynaecological Society (POGS). Hypothyroidism is more comman in women than hyperthyroidism (excess secretion of the hormone), he added.

Women with previously treated hypothyroidism should be aware that their dose of medication may have to be increased during pregnancy. “Such women should contact their doctor,” said Joshi.