Suggest Remedy For Hypothyroidisn And Missed Abortion

Posted on Thu, 18 Dec 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 18 Dec 2014 Answered on

Wed, 14 Jan 2015 Last reviewed on

Question : Hi, I am writing this query on behalf of my wife.
She has just had an Missed Abortion last month.
Visited Gynaecologist in 5th week of Pregnancy, Tests were done.
Her Thyroid (TSH) was high. ( Reports attached)
Started medication 75mcg. (5th week)
Had P/V Spotting in 8th Week.
Ultrasound Report then was OK.
(Saying maturity is 8 weeks, Normal On Going Pregnancy)
Bed Rest Recommended.
Had Thyroid Test in 10th week. (Report Attached).
Again bleeding in 11th Week.
Ultrasound Report (Cardiac Activity Absent, Maturity was only 8 Weeks, MISSED ABORTION),
Had Thyroid test one month after previous test. (Report Attached).
This test has been done recently. Please suggest us.

1. What should be done now after you analyse the Three Reports of Thyroid ?
2. When can we plan for family now, after how many months or so?
3. What all tests needs to be done ?
4. We are very confused with the reports, Was abortion because of Thyroid ?
5. There were no single Visible Symptom of Thyroid, can it occur at the time of conceiving.?

Please suggest us with above question answers and some more advice which you feel is
useful for us.

Regards XXXXXXX

Answered by Dr. Ajish TP (4 hours later)

Brief Answer:
Please see the detailed answer

Detailed Answer:
Hi Mr XXXXXXX XXXXXXX

Welcome to HCM. I have gone through the question and understand your concerns.

Your wife is having hypothyroidism- under active thyroid. I will answer all your questions in detail.

1. You have to repeat a T4 and TSH after 1 month of abortion and adjust the dose based on T4 and TSH. Initially you had high TSH and low T4. On treatment it normalised after 1 month and after 2 months the dose was slightly over than needed. But the stress of abortion will alter the thyroid function reports. So it is better to repeat it after a month and see

2. Pregnancy can be planned once TSH is stabilised below 2.5 miu/ml- probably after 3 months of abortion.

3. Additional tests needed are anti thyroid antibodies and an ultrasound of thyroid. This will help you to find out the cause of Hypothyroidism and will help you in treatment.

4. It could be due to hypothyroidism or any chromosomal disorders in baby. The risk of abortion is about 5 times in hypothyroidism. This can be prevented by treatment

5. Symptoms in hypothyroidism is seen in only 30% of patients. So it can be there before

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

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Prasad