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Taken Carbimazol for overactive thyroid. Scheduled for thyroidectomy. Pregnant. Will the surgery affect the baby?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
I was diagnosed with an over active thyroid 5 months ago, i was put on carbimazol but still that did not control my thyroid. I am scheduled to have a total thyrodectomy next month. I founf out that i am pregnant, i am so worried because i do not know what to do? Can i keep the baby if i still have the operation next month, would i be allowed the operation? Would the baby be born with any defects and what health issues would i face? Is there any danger of aborting the baby to my health before i have the operation?
Posted Sat, 21 Apr 2012 in Pregnancy
Answered by Dr. Hema Yadav 4 hours later
Hello ,
Thanks for posting your query.
Answer 1 Its advisable to go for a medical termination of pregnancy if feasible and acceptable to you since there is high risk of miscarriage and harm to the developing fetus both due to the hyperthyroidism and surgery.You can keep the baby and defer surgery but it wil increase the risk of complications of hyperthyroidism in both mother and baby.
Answer 2 Pregnancies complicated by uncontrolled hyperthyroidism may result in higher incidences of:
Spontaneous abortion (miscarriage)
Preterm labor
Low birth-weight babies
Complications of pregnancy, including pre-eclampsia (a condition associated with hypertension, low blood platelet count, protein in the urine and mental changes) and heart failure.
The treatment of hyperthyroidism in pregnancy is limited because the safety of the baby must also be considered. Usually, drugs such as propylthiouracil (PTU) and methimazole (MMI) or carbimazole are used. While both of these drugs do cross the placenta and can enter the baby's system, treatment is still preferred because of the poor outcomes associated with not treating. PTU is preferred because the methimazole/carbimazole has been associated with a rare scalp condition in the fetus known as "aplasia cutis.

Medications to slow the your heart rate down may also be necessary if you have tachycardia.
The class of drugs recommended is called beta-blockers (metoprolol, propranolol). While these drugs are not thought to be XXXXXXX to the fetus (teratogenic), there have been associations with growth retardation. Low blood sugars at birth and some respiratory problems have also been
Since control of maternal hyperthyroidism is the goal, if medicines do not help then surgery is the next option.
Surgery itself carries the risk of preterm labour or miscarriage.
The last but not the le least, if you successfully carry the baby till term, there is 1% risk of baby having congenital hyperthyroidism.
So the best way to prevent such complications are to first get control over the overactive thyroid either by drugs, radiotherapy or surgery and then plan conception.
Answer 3.
The earlier you get a medical termination of pregnancy the safer it. will be and won't harm your please do not panic and discuss it. with your doctor.
Hope I have answered your query

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