Graves’ and its Complications During Pregnancy

Graves’ disease is an autoimmune disease that affects the thyroid gland. Also known as the Flajani-Basedow-Graves disease, it leads to the enlargement of the thyroid gland almost to its double size, making it overactive and showing up the related symptoms of increased heartbeat, insomnia, muscle weakness, and irritability.

It also affects the eyes, making them bulge out, a condition known as exophthalmos. It affects other systems of the body as well like the skin, circulatory, and nervous systems.

More common in women; Graves disease can be really dangerous if you are pregnant. If you are pregnant or thinking of being pregnant, think again as this disease can do more harm to your baby while you are conceiving than to you. Below given is a list of things that you need to know about the Graves’ disease if you are pregnant.

graves and its complications during pregnancyPregnancy Risks

If you are indeed suffering from Graves’ disease it is best to stabilize your condition by using anti thyroid drugs with a stable maintenance dose of PTU. If you have been treated with surgery or radioactive iodine you must opt for a replacement thyroid hormone and wait at least six months after the surgery or the iodine treatment before conceiving to minimize the effect of radiation on the developing eggs.

Child/Fetus Risk

Remember even if your Graves’ is well under control your child can be affected no matter how long ago you have been diagnosed and treated because in most cases women have a measurable amount of thyroid stimulating antibodies in their system. These antibodies are capable of slipping the placenta barrier and reach your fetus thus causing Graves’ symptoms in the fetus. Although the symptoms of hyperthyroid disappear within a few months after birth from the system of the baby, in some cases it may trigger Graves’ in the child.

Poorly Monitored Graves’

Remember that your pregnancy will result in stirring up your thyroid, thus even if you presume that very little of your thyroid is left after your radioactive iodine treatment or surgery you cannot altogether rule out the risk of a hypothyroid episode. The normal escalation of thyroid hormones can mask a recurrence of your Graves’ attack during pregnancy. Thus it is very essential to keep a close watch of the fetal signs and maternal blood levels. Remember that either too much or too little of your natural thyroid or your synthetic replacement hormone can affect the fetus, also the under treatment with replacement hormone (hypothyroidism) can cause prolonged gestation and underdevelopment in the fetus and overdosing with medication can put both you and your fetus at risk.

Controlling Graves’ During Pregnancy

If you fall victim to the Graves’ during pregnancy the options are unfortunately very limited with drugs because it may affect the fetus and put it at risk. After delivery in such cases breastfeeding should also be avoided because it can suppress the infant’s thyroid. If you are under the dosage of PTU then it should be limited to less than 300mg during your first and second trimester and can be absolutely stopped during the third trimester. You can also opt for thyroid surgery preferably in your second trimester to maximize the chance of your fetal survival.

Iodine treatments specifically are very dangerous whether drops or radioactive because after 10 weeks of gestation iodine crosses over to the fetus resulting in a high risk of fetus death. Thus make sure that you absolutely avoid iodine treatment during pregnancy. You must also avoid beta blocker treatments because they can also affect the fetus or even the infant with suppressing heart rate, respiration, and growth both during pregnancy and nursing period.

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