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Thyroid Problems During Pregnancy

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Margaret Freda
By Margaret Freda Ed.D., R.N., C.H.E.S., F.A.A.N.
"I've been a professional nurse working with pregnant women and parenting families since 1966," says Margaret Comerford Freda. "Pregnant women and parents need to know as much as possible about their own health and that of their children."

Margaret Comerford Freda, Ed.D., R.N., C.H.E.S., F.A.A.N., is a Professor in the Department of Obstetrics &; Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, and also serves as Director of Patient Education Programs for that department. Since 1993, Dr. Freda has been the Consultant for Nursing at the National March of Dimes Birth Defects Foundation and the Chair of the National March of Dimes Nurse Advisory Council. In addition, Dr. Freda serves as the editor of MCN, The American Journal of Maternal Child Nursing.

Dr. Freda received her Master's Degree in Nursing from New York University and her doctorate in Health Education from Columbia University. She has worked in women's health for her entire professional career. Dr. Freda has published 50 research articles in professional journals, and is a frequently invited speaker at nursing and medical conferences. She has written two books: Perinatal Patient Education, published by Lippincott Williams &; Wilkins, and Miscarriage After Infertility, published by Fairview Press, written with her daughter Carrie Semelsberger, who is also a nurse.

Dr. Freda has received several noteworthy awards, such as the Distinguished Professional Service Award and the First National Award for Excellence in Nursing Research from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), the Woman of Distinction Award and the Maternal Child Nurse of the Year Award from the March of Dimes, the Patient Care Award for Excellence in Patient Education from the American Academy of Family Physicians, the Research Recognition Award from Molloy College, and several Outstanding Research Paper awards at national conferences. She serves on the Scientific Advisory Council for the March of Dimes, and was selected to serve on the Select Panel of the Centers for Disease Control to advise on prenatal health. Dr. Freda has developed patient education booklets and videotapes that are now distributed nationally.

Dr. Freda has been married for four decades. She has two daughters, two sons-in-law, three grandsons, and a granddaughter.
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Your thyroid gland, which is located in your throat, is very important for regulating your metabolism, the rate at which your body uses energy. If your thyroid is not functioning properly, the result may be a condition called hypothyroidism, caused by underactivity of the gland, or hyperthyroidism, caused by overactivity. 

Fortunately, very few pregnant women suffer from either form of thyroid imbalance: About 0.6 percent of pregnant women develop hyperthyroidism, and about 0.2 percent have hypothyroidism. Being pregnant does not make you more at risk for developing the disorder. Still, all pregnant women should know the symptoms, since a thyroid disorder can dramatically affect a pregnancy. Here's what you should know.

 Hypothyroidism

 Hyperthyroidism



Hypothyroidism

 

Hypothyroidism has received some press attention lately. A study published in the December 23, 1999, issue of the New England Journal of Medicine found that women who had underactive thyroid glands during pregnancy were four times as likely as women with normal thyroids to have children with low IQ scores. This finding is important, for doctors can treat hypothyroid problems if they are diagnosed early. 

Your health care provider can determine your thyroid function with a simple blood test. (She probably won't test you, however, unless you're experiencing symptoms of an imbalance.) Let your provider know if you have any of these signs: 

• fatigue 

• unexpected amount of weight gain 

• dry skin 

• cold intolerance

• muscle weakness 

Of course, some of these symptoms are a normal part of pregnancy (which is why a thyroid condition is not always recognized), but you have nothing to lose by having a test. If the test comes back showing a low level of thyroid hormone, your provider might give you hormone supplements in a pill form. She'll continue to test you throughout your pregnancy and afterward, to determine how long you'll need to take the supplements.

 

Hyperthyroidism

 

An overactive thyroid gland (hyperthyroidism) can also cause problems during pregnancy: Pregnant women with this condition have a greater chance of giving birth to a low-birth-weight baby. They also have a greater risk of other problems, such as preeclampsia. Preeclampsia, also known as toxemia, is a disease of pregnancy that causes high blood pressure, sudden weight gain, and retention of large amounts of fluid. 

The symptoms of hyperthyroidism are:

• heat intolerance 

• warm skin

• sweating 

• trembling

• weight loss 

• rapid pulse 

Your health care provider can diagnose hyperthyroidism with a blood test and prescribe medication to correct the problem.

Both thyroid problems may also occur following a pregnancy, so be sure you report any symptoms of these disorders to your provider. Abnormal thyroid function occurs in 1 in 20 women within the first year of giving birth. Women who are at greater risk are those from families who have pernicious anemia, rheumatoid arthritis, early graying of the hair, and thyroid problems. For more information, contact the Thyroid Foundation of America at 800-832-9321 or www.tsh.org.

 

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Genetics
I was diagnosed with hypothyroid for my 3rd pregnancy. Just to comment on what the article does not ..

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