Hello XXXXXXX

Thanks for writing to us. I am trying to give answer according to your concern.

First of all, congratulation to her for being pregnant for the first time.

Ovarian cyst is quite common among the women in reproductive age group. As per your history, two cyst on right ovary may be small functional cyst (more common) or serous type ovarian cyst which contains liquid only. It is simple cyst and nothing to worry as it is neither much enlarged nor give any trouble in pregnancy period.

In addition, if those ovarian cysts are large enough (more than 7 cm) according to ultrasound report, then surgical removal of the cyst i.e. ovarian cystectomy can be done during delivery of the baby by caesarean section after consultation with your obstetrician.

She must need to take thyroid medication throughout the pregnancy period in case of diagnosed hypothyroidism to avoid congenital hypothyroidism & low IQ of the baby. Dose of thyroid medication is needed to be adjusted according to blood TSH level.

TIFFA scan stands for Targeted Imaging For Fetal Anomalies and it is an ultrasonic visualization of fetus in detail. It is done around 18-23 weeks of pregnancy to make sure that there are no major or minor fetal abnormalities/ birth defect that can be diagnosed by ultrasound. It is very much safe and you have nothing to worry.

Please consult with your obstetrician/ sonologist to proceed the TIFFA scan.

Follow some basic things for her healthy pregnancy.

1) Take Healthy protein XXXXXXX diet with extra 350 Kcal/day than usual and eat more vegetables & fresh fruits.
2) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
3) Take an adequate bed rest and preferably 8-10 hrs daily in divided schedule.
4) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
5) Maintain personal hygiene including breast & genital care with proper washing.
6) Do periodic check up as per schedule with ultrasound (USG) scan to assess growth & development of fetus.
7) Continue Iron/ calcium supplements till delivery of the baby and up to 6 months after birth of the baby.
8) Take two doses of TT in the 2nd trimester and complete all necessary investigations.
9) Periodic measurement of Weight gain and BP. 10-12 kg weight gain is normal in pregnancy period.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish her for good health and successful motherhood.

Regards,
Dr Soumen

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Hello XXXXXXX,

Thanks for follow up query. I am happy to help you.

1) Normal blood TSH value during pregnancy for an iodine-sufficient population without any autoimmune antibodies as follows:
First Trimester: 0.24 - 2.99 mIU/ L
Second Trimester: 0.46-2.95 mIU/ L
Third Trimester: 0.43 - 2.78 mIU/ L

We can assume from above chart that her blood TSH level in the first trimester at 6.1 is slight higher than normal range.

Therefore, she must continue taking thyroid medication throughout the pregnancy period without taking a break to avoid several complications (like miscarriages, abruptio placenta, pre-eclampsia, PPH etc.) associated with hypothyroid state.

It is advisable to undergo blood test for TSH level at 3 months interval till it comes in normal range. Till then she will take thyronorm medication at present recommended doses (25 mcg) according to your doctor's prescription. Also she will not stop taking medication when she will undergo for blood test. Even in normal range of TSH, a maintenance dose of thyroid medication is required till the delivery of the baby. Iodized salt with healthy diet is advisable. Also concurrent use of other medication or food stuff like sour fruits/ tea/ coffee etc within 2 hrs of taking thyroid tablet is not recommended.

2) Ovarian cysts at 6.4 cm (total size) are not so serious in this stage as both are simple serous cyst (contains liquid only). It does not hamper/ interfere growth & development of the baby. So you have nothing to worry.

Repeat ultrasound scan is needed in third trimester to assess further enlargement of those cysts to make a decision whether confinement of the baby is undergone through caesarean section or normal delivery. If caesarean section is decided by your obstetrician, then ovarian cystectomy or surgical removal of the cyst can be done in the same time.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well & take care of her.

Regards,
Dr Soumen

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Hello XXXXXXX

You are most welcome in XXXXXXX platform.

Wish her good health & successful motherhood.

Now, you can close the discussion and rate the answer.

Regards,
Dr Soumen

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