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Shaping up to get pregnant
Thyroid Gland Disease
Does a mother’s hypothyroidism adversely affect the fetus’ intelligence? Hypothyroidism increases the chances of obstetric complications if not treated properly. When properly treated with thyroid hormones, this worse case can be reduced. The following is the latest article published in a medical magazine of Canada about hypothyroidism during pregnancy.
Hypothyroidism during pregnancy
is quite common and about 4% of women suffer from thyroid gland diseases or take medications for it. Reportedly, more than 2% of women witness a rise in thyroid stimulating hormone in a test performed during pregnancy. Hypothyroidism induces obstetric complications such as fetal death, obstetric hypertension, placental abruption, or negative perinatal outcome. A 12-week-old fetus starts generating thyroid hormones, so until then, it is dependent solely on a mother’s thyroid hormones. A study shows that mothers who haven’t had their hypothyroidism treated saw their thyroid stimulating hormone rise, and their babies were born with IQ lower than that of normal babies by 7.
Another study shows
that a mother’s low thyroid hormones at 12 weeks of gestation are likely to cause disorders in the fetus’ intelligent development. Luckily, treatment via thyroid hormones even after the first trimester can work for a fetus’ intellectual development. Plan your pregnancy again and find out if you have hypothyroidism through medical diagnoses. If you do, go through a proper treatment process and you’ll be able to give birth to a healthy child.
In what way does
hyperthyroidism affect an expectant mother and her baby? Women with hyperthyroidism experience a reduced rate of conception. Its effects on the fetus include low birth weight, growth delay, premature labor pains, miscarriage, stillbirth, or fetal death, which increases the risk of maternal death. Therefore, failure to adjust hyperthyroidism heightens the risk of malformation. Mothers who have this symptom must control the amount of medication they take before and after pregnancy.
I’m an expectant mother with diabetes. What should I do to prevent fetal malformation?
Diabetes that requires
insulin prescription for blood sugar must be properly managed and treated before insemination. The embryo in the first trimester is susceptible to malformation due to high blood sugar, therefore, the risk of neural tube defects, congenital heart disease, and polycystic kidney rises by up to five times if the blood sugar level is not kept in check. What is important during a counseling session before pregnancy is the patient’s health condition including the kidneys, heart, and retina. To put the focus on the prevention of malformation, a patient’s glycosylated hemoglobin (HbA1c), an indicator of blood sugar level management, should be evaluated for the past few months, while adjusting the blood sugar level through exercise, food, and insulin intake. Also, the patient must start taking 4-mg insulin a month before pregnancy. She should keep her blood sugar level in check even during pregnancy to prevent bleeding caused by macrosomia or damage to the parturient canal or the baby.
Macrosomia, also known as big baby syndrome, is defined as fetus or infant weight above 4,000 grams regardless of the gestational age. The cause is yet unclear, but they tend to be born from mothers who are tall and heavy. Diabetes is one of the causes.
Type of diabetes mellitus
Diabetes is divided largely into insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). IDDM is also called Type 1 diabetes (T1DM). They appear mainly before the age of 30 in individuals deprived of insulin. To maintain a normal life and prevent diabetic ketoacidosis, a potentially life-threatening complication in patients with diabetes mellitus caused by a shortage of insulin, from happening, insulin treatment is a must. NIDDM is also known as Type 2 diabetes (T2DM) and often appears at the age of 40 and over. Ketoacidosis is rare in this type of diabetes, which doesn’t necessarily require insulin intake, but some patients use it to keep their blood sugar level in check.
Glycosylated Hemoglobin (HbA1c)
Human red blood cells contain a protein called hemoglobin for transporting oxygen. When the blood sugar increases, some of the glucose inside the blood blends with hemoglobin. This glucose is called glycosylated hemoglobin (GH). Once GH is formed, it is maintained until the red blood cells die out. When the blood sugar level is higher, the GH contained in the red blood cell also increases.
The amount of GH
is indicative of 8-weeks’ worth of blood sugar on average, which can be used as an indicator to determine whether the blood sugar was properly managed during that period. If it falls below 7%, it was well adjusted. Congenital malformation associated with diabetes occurs at about 8 – 9% of the total and the rate can be reduced to 1% if the symptom is kept in check. So don’t be discouraged and consult your doctor before pregnancy to adjust your blood sugar level while taking folic acid.
Does kidney disease adversely affect a pregnant woman and her fetus?
Some kidney diseases are
known to be worsened by gestation. Glomerulonephritis increases the occurrence rate of hypertension during the final trimester. If you had kidney surgery, the infection rate increases and the kidneys’ function deteriorates. If you have calculus, you are more prone to an infection. Furthermore, blood vessel disorders related with delayed growth, premature birth, and death in the perinatal period may occur. If toxemia ensues or hypertension worsens, artificial abortion is unavoidable. Moreover, some angiotensin converting enzyme (ACE) inhibitor used in the treatment of hypertension such as Renitec can induce kidney deformation or renal insufficiency in the fetus. Therefore, you must stop taking ACE inhibitor and change to another medication when you plan gestation.
Polycystic renal disease is
a cystic genetic disorder of the kidneys. It appears alongside the symptoms of hypertension in the late 30s. Like most other chronic renal diseases, the success of pregnancy depends on the severity of hypertension and kidney function. However, it is known that pregnancy doesn’t aggravate the symptoms. The complications in the perinatal period are similar to the complications experienced by those with normal kidneys but a case of toxemia becomes more frequent. A mix of hypertension medications and toxemia may result in low birth weight, delayed growth, and premature birth. As it is a cystic genetic disorder, 50% of the babies may suffer from the same polycystic renal disease experienced by their mother.
Polycystic renal disease
There are two types of polycystic renal disease. One is autosomal recessive. It induces the formation of multiple fluid-filled cysts inside the womb, leading to kidney malfunction. Of course, the patient can’t generate urine, resulting in anhydramnios. As a result, the fetus fails to develop lungs and dies in the end. A mother who had this baby has a 25% chance of experiencing the same symptom in her next gestation. Meanwhile, the other is autosomal dominant and the babies born with this will suffer from hypertension in their 30s and 40s. If it continues, cysts may appear in the liver, causing cerebral aneurysm. Pregnant women with this symptom are known to transmit it to their children at a rate of 50%. Therefore, in-depth genetic counseling is important before pregnancy.
I suffer from epilepsy. Is it okay for me to have a baby?
Some early research shows
that epilepsy has something to do with the birth of deformed children, but more recent ones report that the two have no correlation. Anticonvulsants are what cause a fetal deformity. Inevitably, the more anticonvulsants you take, the higher the chances of malformation become. Therefore, a perinatal examination is required when you become pregnant. If both spouses are epileptic or have genetic convulsions, genetic counseling is needed. If the patient has no convulsions for two years, and at least for 6 months before insemination, you should consider stopping the medication. If you have no other choice but to keep taking it, choose the best possible medication and take a minimal amount.
Also, you should take
4-mg folic acid from 3 months before gestation until 12 weeks of gestation to prevent neural tube defects such as agyria or spina bifida amongst other malformations. During the third trimester, a pregnant mother gains weight and increase in her ability to remove medical substances, lowering the concentration of medical substances in the blood, which makes it difficult to control convulsions. In this case, you should closely monitor the level of medication in the blood. In addition, take vitamin K from 4 weeks before childbirth to prevent hemorrhagic diseases in the newborn.