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What are the risks during pregnancy in hypothyroidism?

Q: I am a 26 year old female and was detected to have Hypothyroidism 4 years back. Since then I have been regularly taking Eltroxin 1/2 tablet daily along with Aldactone thrice a day. The boy whom I intend to marry too has hypothyroidism for the past 10 years and is taking Eltroxin 1 1/2 tablets daily. What are the chances of: a) a normal pregnancy; b)normal healthy baby being born and c) precautions to be taken for the same?

A:Make sure you and your husband are taking the right dose (not too much, not too little) of thyroxin by getting your T4 and TSH done every 6 months. This is important to ensure you have no problems with fertility. You will have to stop your Aldactone when planning a pregnancy. The chances of a normal pregnancy are the same as for any other normal woman. You have to make sure your blood levels of free T4 and TSH are tested and kept normal with adequate thyroxin when: a) you are planning to get pregnant; b) you are pregnant in the middle of your first trimester; c) you are pregnant in the middle of your second trimester; d) you are pregnant in the middle of your third trimester; and e) 2-3 months after delivery. This is because it is critical that your circulation has enough thyroxin for the baby's needs in the first trimester, and because your needs for thyroid hormone are likely to increase during pregnancy (and decrease afterwards). The chances of having a normal baby are almost the same as for any other normal woman. Some forms of hypothyroidism can affect the baby, but a serious problem is very rare. However, at birth, the baby's blood levels of free T4 and TSH are tested: either in the cord blood at the time of birth or in the venous blood at age 5-6 days. If the result is abnormal, it should be repeated in a day or two, and if still abnormal, a thyroid scan should be done if possible, and medication started as soon as possible. If the report is normal, file it and forget it.

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