Pregnancy is the most worrying time, and if you suffer from hyperthyroidism at this time it is even more of a headache. It is also difficult to diagnose pregnant women, so how can pregnant women correctly determine if they are suffering from hyperthyroidism? Here is how to diagnose hyperthyroidism during pregnancy and what to look for. The causes of hyperthyroidism during pregnancy are basically the same as those of hyperthyroidism during non-pregnancy, with Graves’ disease being the most common. This is followed by toxic nodular goiter and autonomic hyperfunctioning adenoma of the thyroid gland. In addition, hyperthyroidism can occur in cases of severe pregnancy vomiting, staphyloma, malignant staphyloma and chorioepithelial carcinoma. How is hyperthyroidism diagnosed during pregnancy? Pregnancy and childbirth are a necessary part of every woman’s life after marriage. Some of the symptoms that women exhibit during pregnancy are quite similar to those of hyperthyroidism, which makes the diagnosis of hyperthyroidism during pregnancy difficult. In normal pregnant women, due to the hypertrophy of the anterior pituitary gland, the thyroid gland may become enlarged, and due to the increase of estrogen level in the blood, the thyroid binding globulin (TBG) may rise, and the total serum T3 and T4 may also rise accordingly. Because of these changes, normal pregnancy can be mistaken for hyperthyroidism, and true hyperthyroidism can be misunderstood as pregnancy. Therefore, the diagnostic criteria for pregnancy with hyperthyroidism should be higher than those for hyperthyroidism alone. The basic requirements are: if the weight does not increase with the number of months of pregnancy, if the pulse rate at rest is more than 100 times/minute, and if the proximal muscles of the extremities are wasted, the diagnosis of hyperthyroidism is suspected, and FT3 and FT4 levels are detected. If there are also eye signs, diffuse goiter, vascular murmur and tremor in the thyroid area, toxic diffuse goiter (Gravexs) can be diagnosed after excluding other causes of hyperthyroidism or thyrotoxicosis. How does hyperthyroidism affect pregnancy? It is recommended that women diagnosed with hyperthyroidism be treated for hyperthyroidism and wait as long as possible until they are cured before becoming pregnant. For pregnant women with stable hyperthyroidism who are already pregnant and are not planning to have a pediatric abortion, it is recommended to use drugs that are not teratogenic and pass through the placenta less often, such as PTU. If 131 iodine treatment is applied before pregnancy, pregnancy should be carried out only after six months of contraception. If a pregnant woman is currently in a hypothyroid condition and is undergoing thyroid hormone supplementation, she should not stop the medication after pregnancy because thyroid hormone has no effect on the baby, and stopping the medication may cause miscarriage. What is the health care method for hyperthyroidism? Pregnant women with hyperthyroidism are prone to fetal growth restriction (FGR) and low birth weight of newborns because of their hyper-metabolism and inability to provide adequate nutrition for the fetus. How to check: Pay attention to the growth of mother’s weight, uterine height and abdominal circumference, and have fetal ultrasound examination and fetal weight estimation every one to two months. Increase nutrition and rest, and take the left side position. If FGR is detected, hospitalization should be promptly conducted, and fetal ultrasound examination and fetal weight estimation should be performed every 1~2 months. Pregnant women with hyperthyroidism taking ATD may cause fetal hypothyroidism: fetal goiter, slow weight gain, slow fetal heart rate of 110~120 beats/min, reduced fetal movement, low amniotic fluid. In congenitally hypothyroid fetuses, the prognosis may be poor. There is little experience on how to treat the fetus, but it is suggested that umbilical cord puncture is feasible and cord blood is taken to check the thyroid function in order to confirm the diagnosis. Pregnant women with hyperthyroidism are prone to preterm delivery. In case of preterm labor, the fetus should be actively preserved, avoiding β-receptor stimulants during treatment, bed rest as much as possible, and using fetal preservation drugs such as magnesium sulfate, Turinal, and procaine. In addition, pregnant women with hyperthyroidism are prone to complications of hyperemesis in the late stage, so attention should be paid to early calcium supplementation, low-salt diet and nutritional guidance.