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Does Thyroid Disorder Need Surgery During Pregnancy?

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Posted on Tue, 5 May 2015
Question: Thyroid disease needs surgery while pregnancy?
doctor
Answered by Dr. Binu Parameswaran Pillai (27 minutes later)
Brief Answer:
Only in second trimester

Detailed Answer:
Good day,
It depends on type of thyroid disease. Thyroid cancer and uncontrolled grave's disease or large goiters may need surgery. However, as far as possible, surgery is avoided until pregnancy is completed.

If an unavoidable thyroid surgery is required during pregnancy, it is done during the second trimester ( avoided in first and third trimester).

Reards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (13 minutes later)
TPO report is attached. In this situation, surgery is needed?
doctor
Answered by Dr. Binu Parameswaran Pillai (11 minutes later)
Brief Answer:
No need of surgery just for elevated Anti TPO

Detailed Answer:
Thank you for attaching the reports. I can see that she has subclinical hypothyroidism with TSH 12 and normal T4 and T3. This is called subclinical hypothyroidism. Anti TPO is high which means that she has autoimmune hypothyroidism ( Hashimoto's disease).

In this situation she require treatment with levothyroxine ( ELTROXINE or THYRONORM). How many weeks of pregnancy now??
We need to aim for a TSH of < 2.5 during first three months and TSH of < 3 during next 3 months.

Does she have a thyroid swelling?

SHE DOESN't NEED SURGERY JUST FOR elevated Anti TPO.

I can see that you are from XXXXXXX I would strongly advice you to meet one of the endocrinologists there ( XXXXXXX HRUDAYALAYA, MANIPAL HOSPITAL, St.John's hospital, Ramiah hospital, Vydehi hospital, Columbasia hospital etc have endocrinologists).

Avoid going to a surgeon or a physician. Because, pregnancy and thyroid disorder need special care and an endocrinologist is better to manage this.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (15 minutes later)
Scanning report,Blood test and urine analysis are attached. She is having light swelling. Can she take thyrorite which was provided by Doctor? We are going evening to endocrinologist at our place(got appointment also).
doctor
Answered by Dr. Binu Parameswaran Pillai (56 minutes later)
Brief Answer:
Need Thyrorite

Detailed Answer:
The obs scan report was not clear. Urine and blood reports were okay. There can be a small swelling when TSH is high and also due to pregnancy, there can be mild thyroid swelling.

You can take a good quality Thyroxine ( Eltroxine or Thyronorm). Even thyrorite is okay. She will need at least 50 mcg Thyroxine to start with. Repeat TSH after 4 weeks. If the swelling is mild ( and if there are no nodules), no need of any surgery.

Regards
Binu
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1438 Questions

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Does Thyroid Disorder Need Surgery During Pregnancy?

Brief Answer: Only in second trimester Detailed Answer: Good day, It depends on type of thyroid disease. Thyroid cancer and uncontrolled grave's disease or large goiters may need surgery. However, as far as possible, surgery is avoided until pregnancy is completed. If an unavoidable thyroid surgery is required during pregnancy, it is done during the second trimester ( avoided in first and third trimester). Reards Binu