Pregnancy is a time of substantial hormone fluctuations, which are necessary to prepare for and successfully grow a baby to term. With huge dips and dives in hormone production, however, some hormone-regulated organs may be affected. Chief among those influences on hormone production is the thyroid. This gland, located at the base of the neck below where an Adam’s apple would be, regulates hormones that affect the body’s organs. If the thyroid is overproducing thyroid hormones, called hyperthyroidism, the body’s functions speed up, while underproduction of thyroid hormones leads to hypothyroidism and slowed bodily functions. Moreover, pregnancy-related hormones, such as hcG (human chorionic gonadatropin), increase thyroid hormonal output, which doctors may not be able to detect with a physical examination of the neck. The thyroid may not be enlarged enough to be felt by a doctor’s hands, and it may not necessarily be a problem for the patient in some cases.
While many pregnant women feel no effects from an unnoticeably enlarged thyroid, more serious thyroid problems not only affect their bodies, but also their developing babies. This is especially true in the early weeks of pregnancy, when the fetus’s thyroid is not yet formed or is too immature to support its own cerebral and neurological growth. As such, controlling hyper or hypothyroidism is a medical priority. In the reverse, failing to investigate troubling symptoms that may indicate a thyroid issue or failing to take immediate and appropriate action to manage these conditions in the near-term, and on and ongoing basis until the baby is born, can prove disastrous. The mother’s and baby’s health may be jeopardized by negligent medical professionals who do not diagnose, treat, and manage thyroid disorders while the delicate, growing child and pregnant woman are in their care.
Checking Thyroid during Pregnancy
When a pregnant woman complains of her heart pounding or unexplained hand trembling, her doctor should be asking her about other symptoms, such as heat sensitivity or fatigue. And if they notice she is losing rather than gaining weight, a physician should be prompted to investigate the thyroid, especially if the woman had thyroid problems before pregnancy. When a doctor sees a patient in the early weeks of pregnancy, they may take for granted that weight loss is caused by morning sickness, when a woman feels nauseous and often eats less. She may even vomit daily at first. The quick assumption, possibly combined with a careless medical history review that reveals past thyroid problems, can lead to a missed diagnosis of thyroid problems that threaten the health of the pregnant woman and her developing baby. Pregnancy-related medical malpractice claims are all too often rooted in missed diagnoses that cause harm to patients.
Common Thyroid Problems in Pregnant Women
If the expectant mother came into the pregnancy with thyroid conditions or diseases that affect the thyroid, such as Graves or Hashimoto’s disease, a physician must carefully consider how to care for the woman for the entirety of the pregnancy. Graves disease is an autoimmune condition that causes the thyroid to overproduce hormones, while Hashimoto’s disease is an autoimmune disease that triggers antibodies to attack and damage the thyroid, causing underproduction of thyroid hormone. Graves disease can be caused by pregnancy too. Some women experience Graves disease when the body produces too many thyroid-stimulating antigens. A doctor who suspects Graves disease should run blood tests to investigate for the presence of these antigens. Less often, hyperthyroidism is caused by excess hcG, which may necessitate a timely diagnosis and treatment plan when the woman is having frequent episodes of vomiting and nausea.
Another thyroid condition, postpartum thyroiditis, is, as the name suggests, an inflamed thyroid that women experience after giving birth. This condition may continue for up to a year afterward. A woman’s post-delivery immune response may cause hyperthyroidism, followed by hypothyroidism when the thyroid suffers damage. Not all women experience both and the condition is more common to diabetics. Symptoms of hypothyroidism are difficult to detect because they often appear much like postpartum depression, with excessive fatigue, fluctuating moods, rapid heartbeat, cold or hot sensitivity, irritability, and brain fog. Some women may be asymptomatic, but blood tests can detect the condition.
How do Doctors Control Thyroid during Pregnancy?
Thyroid conditions and diseases are generally treated with medications, but that may be a more complex decision during pregnancy because whatever the mother ingests can affect the fetus. For instance, medications that lower thyroid function may lead to hypothyroidism in the fetus, and those that stimulate the thyroid may cause hyperthyroidism at the other end of the spectrum. Thus, a treating physician must weigh the treatment considerations, including monitoring, regular hormone level testing, drug therapies, and surgery.
Hyperthyroidism is treated with precisely measured and adjusted medication to treat the mother without damaging her unborn child. In the interests of accuracy, a physician may need to consult an endocrinologist to confirm the correct dose. For hypothyroidism, treatment ranges from monitoring to medication, like Beta blockers that regulate heart rhythms. A diet high in iodine found in eggs and iodized salt may also be prescribed since iodine is needed to make thyroid hormones. The challenge with thyroid conditions in pregnancy is not only selecting the right medication dose, but also choosing the right medication at the correct time.
Risks of Untreated Thyroid Disorders during Pregnancy
Thyroid hormone levels may rise or lower at different points in pregnancy and may lead to serious problems for mother and baby if left unmonitored. Untreated hyperthyroidism can cause high blood pressure or preeclampsia and heart problems in the pregnant woman. She may also miscarry or birth a premature newborn or low-weight baby, both of which may bring problems of their own. In addition, the baby can suffer irregular heartbeat and even heart failure. On the other end of the spectrum, hypothyroidism can cause fatigue, sensitivity to cold, cramps, and constipation. A foggy brain often occurs as well, due to Hashimoto’s disease. Like hyperthyroidism, the condition can be dangerous to the fetus, causing heart failure, low birth weight, miscarriage, stillbirth, and anemia. Preeclampsia is also a risk. Since thyroid hormones affect a fetus’s developing brain and spinal cord, hypothyroidism threatens to affect a baby’s cognitive and neurological functioning. They may be born with intellectual and neurological deficits that require life-long therapies and care.
Medical Negligence with Pregnancy Thyroid Conditions
Lack of Communication about Off Thyroid Levels
A common medical malpractice problem involves lack of communication between healthcare team members, so a healthcare team that is less coordinated may be at fault for any injury or complications for the pregnant women with thyroid issues or her developing fetus. Failing to refer patients to specialists or consulting with specialists for complex cases proves equally problematic and often, catastrophically harmful. A physician must be knowledgeable enough to know, and willing to admit, that they are out of their expertise area.
Medication Mistakes while Treating Thyroid Conditions
Medication errors while treating pregnancy thyroid conditions are also common sources of negligence, especially when administration of the medication frequently adjusts. Thus, when an obstetrician has thyroid tests run and discovers hyperthyroidism but orders the wrong medication dose, the mom and her baby may be harmed. Likewise, thyroid conditions may worsen or improve throughout the pregnancy, and so the closely monitored patient may have the medications adjusted from trimester to trimester, especially if there are side effects or allergic reactions to the medication. Some thyroid medications decrease liver functioning or cause rashes. Another medication side effect is jaundice, a yellowing of the skin, accompanied by abdominal pain, fever, fatigue, itchiness, or appetite decrease. If serious side effects prevent use of the antithyroid medications, surgery to remove part or all of the thyroid may be the solution, optimally in the second trimester.
Missed Thyroid Diagnosis and Failure to Run Thyroid Tests
Doctors with patients who have diabetes, a history of thyroid conditions, a history or family history of autoimmune disease, or received radiation treatment for a thyroid condition must be extra watchful for thyroid spikes or dips during the pregnancy. Since simple blood tests detect the antigens in the blood for hypo or hyperthyroidism, it is crucial for practitioners to be diligent. In the same vein, it is incredibly important not to confuse the fatigue, nausea, brain fog, or abdominal pains that often come with thyroid problems, with ordinary conditions, such as morning sickness, pregnancy tiredness and mental dullness. Cautious doctors can rule out thyroid conditions with testing when such symptoms are reported by patients.
Careful practitioners also keep up on the developments and standards in their practice area. For example, knowing the standard TSH (thyroid stimulating hormone) and thyroid hormone levels in the mother during pregnancy by careful and frequent monitoring is important, as is recognizing the postpartum signs of thyroid imbalances. Aware that hyperthyroidism and hypothyroidism raise the risk of miscarriage, prematurity, and stillbirth, physicians must keep the thyroid output under control and be prepared for the possibility of a premature baby or one born with immediate intensive care needs. Doctors who are not practicing according to the recommendations of the American Thyroid Association on when to test pregnant women and what to look for, including regular testing of THS to evaluate the thyroid’s functioning, may negligently cause their patients preventable injury.
Did you or your baby Suffer Complications Failure to Diagnose or Treat Thyroid Issues?
As is the case with all pregnancy and childbirth malpractice claims, negligent doctors and other healthcare providers risk two lives, not one, when they provide suboptimal care or make mistakes. Ultimately, you and your baby should not have to suffer for the avoidable errors of a doctor, nurse, hospital, clinic, or other medical facility. The birth of a baby should be a time of joy and celebration, not anguish and tears, thinking about your baby’s future health and happiness. If you suffered complications, your baby was born premature or injured, or someone you love suffered the adverse effects of untreated thyroid conditions during pregnancy, your healthcare provider may be responsible to support your temporary and lifelong care. The pain and suffering inflicted upon you and your family can be equally compensated with a successful lawsuit.
To speak with a seasoned pregnancy and birth malpractice attorney regarding your potential claim for thyroid-related negligence, contact our team at 866-708-8617. Our New Jersey lawyers have extensive experience assisting clients who find themselves in your situation and we provide absolutely no-cost consultations. Call or send us a message for your free case review today.