Thyroid Disease in Pregnancy 101: Graves’Disease

Thyroid Disease in Pregnancy 101: Graves’Disease

Thyroid Disease in Pregnancy 101: Graves’Disease

Dr.Guttler’s comments on this article.

  1. All patients need to have thyroid tests before they get pregnant or as soon as they know they are pregnant.
  2. This complication of severe thyrotoxicosis could have been  found and treated early in the pregnancy not after terrible complications have occured.
  3. Third world country with poor medical care are the real cause of her condition.

Pre-eclampsia (blood pressure with signs of organ damage) and thyroid disease, in her pregnancy.

Expert: Why you should be wary of your thyroid levels when pregnant

A keen eye will tell how distraught Ben Ondijo is. Behind the smile and the chuckles he sneaks in during our conversation, lies a troubled first-time father.

His two-month daughter still does not know how a mother’s embrace feels, or the sweetness of her milk. Sophie Kasaya Abdalla, Ondijo’s wife, is lying in a hospital bed in a coma. A bad omen struck on the world’s famous unlucky date – Friday, April 13.

Sophie fell ill and was admitted to St Francis Hospital in Kasarani. There she was diagnosed with preeclampsia (blood pressure with signs of organ damage) and thyroid disease, in her pregnancy.

When her state did not improve, the doctors recommended she be moved to Kenyatta National Hospital (KNH).

“I, however, asked that she be moved to Mater Hospital since I have insurance,” said Ondijo, who was back in the country from a work trip in Ghana, but was still stuck in Mombasa.

Just 24 hours after admission at Mater, she underwent an emergency caesarean section and was moved to High Dependency Unit (HDU).

Ondijo was on time to see his wife wake up from the anaesthesia. “She was okay, we even chatted,” he said.

Then he requested to go and see their baby in the nursery: “On my way, I received a call that instructed me to come back to the wards.”

His wife had gone into a coma. “I was told she developed cardiac arrest, but she was resuscitated. Her brain was damaged up to 70 per cent. She cannot do anything by herself,” he said.

Ondijo was informed that the only way to save her was to carry out a procedure known as radio-iodine therapy, a form of cancer treatment that would reduce her thyroid levels by killing the secreting glands.

In her state, he was informed, no surgery could be attempted as any slight touch on the thyroid glands would make them burst and that will be fatal.

Of all the pregnancy related complications, to Ondijo, thyroid was the least of them.

The most he expected to spend for his wife’s delivery was Sh100,000 – in the event of a C-section. However, with all complications, the bill went up to Sh6 million.

“If I knew, I would have increased my insurance premiums just in case,” he says.

Dr Eva Njenga, an endocrinologist, noted that in most people, not only pregnant women, the symptoms of thyroid disease are often not recognised or are thought to be due to other diseases.

“A blood test is then carried out after history taking and physical examination to determine if there is presence of thyroid disease,” said Njenga.

Thyroid disease in pregnancy, she said, does not necessarily have to be genetically influenced. “Some pregnancy-related hormones may cause a marked rise in thyroid hormones precipitating symptoms. After delivery, the symptoms may resolve in some patients,” she said.

Similarly, as revealed by Dr Omar Ahmed, thyroid disease can also be caused by people diagnosed with graves’ disease. This is because for those who have this rare condition, they produce antibodies that attack the thyroid glands.

In Ondijo’s case, his daughter is said to have been born at 33 weeks instead of the expected 37. She (daughter) also had her thyroid levels high and was put on a series of tests and treatments.

In this case, Omar warns that it is wise for women to disclose if they are pregnant when they are diagnosed with thyroid disease.

“Some drugs can pass through the placenta and end up affecting the unborn child,” he said.

According to CF Otieno, an endocrinologist who has been attending to Sophie, her case is the first one he has seen in his medical career.

“I have treated and attended to many patients with hyperthyroidism, but not thyroid storm. There is nothing the doctors did to help Sophie be alive today. This is God,” says Otieno.

One, however, needs to see a doctor if their pregnancy symptoms exhibit themselves to their extreme, which may include increased sensitivity to cold, depression, poor memory and tremor-shaking of hands.

“If it is caused by graves’ disease, a major symptom is that these individuals’ eyes appear like they are popping out,” said Dr Omar.

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