by: Robert Baird
Your body’s need for thyroid hormone increases dramatically during the first half of your pregnancy. This increased need may begin as early as one week after your missed period. Women with hypothyroidism need to increase thyroid hormone drugs as soon as they conceive. As soon as you know you are pregnant you should increase your levothyroxine dose by about one third (usually an extra 25-50mg a day) and see your doctor soon. Your thyroid function will be checked often in early pregnancy and your medication adjusted as needed. Appropriate management of hypothyroidism during pregnancy is very important even borderline low thyroid hormone levels may impact your baby’s neurological development. Screening for thyroid function is recommended in women over 35 with any autoimmune condition such as SLE or diabetes or in women with a strong family history of thyroid disease. ObesityIf you are obese (body mass index over 30) you are more likely to develop problems in pregnancy (including miscarriage) some of which may be due to unrecognized diabetes. You are also more likely to develop diabetes and high blood pressure. Obese women often need a cesarean delivery and have a higher rate of complications. High Blood Pressure
If you are being treated for high blood pressure you should see a doctor before conceiving. Some drugs used to treat high blood pressure should be avoided your doctor will make sure you take a type that is safe. You may be at risk of complications such as preeclampsia during your pregnancy. It is important that your kidney function is checked in the first trimester so that if protein is found in your urine later in the pregnancy you have a point of reference. Your doctor is likely to monitor your baby with nonstress tests from 32 weeks. It is vital that you take your medication during pregnancy high blood pressure can cause bleeding in the placenta and be harmful to the baby. Depression
Depression may worsen with the stresses of pregnancy and the accompanying hormonal shifts. For this reason do not abruptly discontinue your medication with out medical supervision. Serotonin reuptake inhibitors (SSRI’s) like fluoxetine and sertraline can be continued during pregnancy. Your obstetrician or care provider should communicate closely with your mental health provider prior to any changes in medications. Acne
Pregnancy can worsen acne. Before you conceive ask your doctor about the safety of your current treatments. Isotretinoin can cause significant birth defects, and any woman taking this drug should be using a reliable form of birth control. It is wise not to take any antibiotics for acne with out checking with your obstetrician.