Goiter during pregnancy

During pregnancy, the mother's body produces hormones that cause the thyroid gland to overproduce hormones, leading to an increase in the size of the goiter.

Ms. Nguyen Truc Quyen (33 years old, Tay Ninh ) recently underwent surgery to remove a goiter (thyroid tumor). She was discharged after 24 hours, her health is stable, and there are no complications.

In 2022, Ms. Quyen underwent a health check-up and discovered a benign goiter measuring 0.5 cm. During her pregnancy, the goiter increased in size, and she took medication as prescribed by her doctor. After giving birth, the goiter swelled, affecting her appearance. Simultaneously, she feared she might have thyroid cancer.

After giving birth, Ms. Quyen's goiter increased rapidly in size. Photo: Nguyen Tram

In mid-June, she visited the Breast Surgery Department at Tam Anh General Hospital in Ho Chi Minh City. Dr. Doan Minh Trong, a specialist in Breast Surgery, observed a large lump in the patient's neck area and ordered an ultrasound, which revealed its size to be 6 cm. A fine-needle aspiration biopsy under ultrasound guidance confirmed it was benign. The large size and rapid growth of the lump caused the patient to lose confidence. Without surgery, the lump could damage the laryngeal nerve and compress the esophagus, making swallowing difficult and affecting her ability to eat.

"If thyroid surgery is not performed carefully, patients risk hoarseness; bleeding within 24-48 hours after surgery; numbness and weakness in the hands and feet due to the surgery affecting the parathyroid glands; and fluid accumulation at the incision site causing swelling and edema in the neck area," Dr. Trong assessed.

On June 26th, Dr. Trong stated that after 60 minutes, the surgical team completely removed the left thyroid lobe containing the large tumor, minimizing damage to vital organs such as the recurrent laryngeal nerve, parathyroid glands, and blood vessels. Immediately after the surgery, Ms. Quyen was able to speak normally without hoarseness.

Dr. Trong further explained that during pregnancy, the mother's body produces gonadotropin-releasing hormone (GnRH), causing the thyroid gland to become overactive and about 10-15% larger than before, especially in women with iodine deficiency. Women who develop goiter during pregnancy will see a rapid increase in goiter size.

Dr. Trong and his team of doctors from the Breast Surgery Department, Tam Anh General Hospital, Ho Chi Minh City, performed thyroidectomy surgery on Ms. Quyen. Photo: Nguyen Tram

Benign goiter is a condition where the thyroid gland is abnormally enlarged or swollen due to the overgrowth or uneven growth of thyroid cells. This condition is usually not dangerous.

However, large benign goiters can also lead to nerve damage (phthong nerve paralysis, Horner's syndrome, and recurrent laryngeal nerve paralysis). Additionally, an oversized thyroid gland can compress the esophagus, making swallowing difficult and affecting eating habits, leading to nutrient deficiencies.

There are many causes of goiter, including iodine deficiency affecting 2.2 billion people worldwide. Other causes include: genetics, living in iodine-deficient areas, Graves' disease, thyroiditis, and pituitary tumors that secrete thyroid-stimulating hormone.

Most benign goiters have no signs or symptoms other than swelling in the neck. In many cases, the goiter is so small that it is only discovered incidentally during a routine health check-up, test, or X-ray.

For small goiters with normal thyroid function that don't cause swallowing difficulties or breathing problems, regular check-ups and monitoring are sufficient without treatment. However, for large goiters that affect aesthetics, thyroid function, or cause difficulty swallowing or breathing, doctors may prescribe medication or surgery.

Dr. Trong advises pregnant women with goiter to have regular check-ups to ensure the health of both mother and baby. In addition, their daily diet should include plenty of seafood and iodized salt; and they should adopt a healthy lifestyle (avoiding staying up late, limiting alcohol and tobacco consumption, and exercising for at least 30 minutes daily) to improve overall health and prevent many diseases such as diabetes, goiter, and hyperthyroidism.

Duc An

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