Endocrine Conditions in Pregnancy

Medical Disorders of Pregnancy menu

Overview

If you have diabetes or other endocrine conditions, it is important to carefully manage your health before, during and after pregnancy.

In many cases, endocrine conditions can be effectively managed by a midwife or obstetrician. In complex cases, patients will see a maternal-fetal medicine (MFM) specialist in our clinic.

Our MFM specialists are high-risk obstetricians who care for patients with endocrine and other health conditions, such as type 1 and type 2 diabetes, hyperthyroidism and hypothyroidism, pituitary disorders and others.

If you are not yet pregnant, we recommend talking to your family physician or endocrinologist before planning a pregnancy.

Our care

Learn more about the specialized care provided at Mount Sinai Hospital for Medical Disorders of Pregnancy.

This content is intended for informational purposes only and is not intended to be used or relied upon for any diagnostic or treatment purposes. It does not replace the need for consultation with a health-care professional. Please speak with your health-care professional for questions about your health.

Your pregnancy care

You might be concerned about potential harm to your baby or the safety of your medication during pregnancy.

We will help you understand your treatment choices so that you can make the best possible decisions for you and your baby. It is important to us that you actively participate in decision-making about your care.

Our MFM specialists work closely with endocrinologists who have expertise in pregnancy. You will have prenatal appointments at the Medical Disorders of Pregnancy Clinic. You will also have appointments with the Leadership Sinai Centre for Diabetes’ pregnancy clinic.

Treatment

Diabetes in pregnancy

When you have diabetes, both high and low blood sugar levels can increase risks to you and your baby during pregnancy. These levels can fluctuate during pregnancy and usually require changes in your medication.

Your MFM specialist will work with you to develop a care plan that is specific to your needs. Pregnancy care will focus on regulating your blood sugar levels and monitoring the health of both you and your baby.

Your care plan may include any of the following:

Regular testing of blood sugar levels
Monitoring symptoms associated with high and low blood sugars
Monitoring your blood pressure
Adjusting medication such as metformin or insulin to control blood sugar levels
Additional ultrasounds to monitor placental and fetal health
Fetal echocardiogram (heart ultrasound)

Thyroid conditions in pregnancy

In the first few months of pregnancy, the baby relies on you for thyroid hormones. Thyroid hormones are especially important for your baby's brain development.

Our experience in caring for patients with endocrine conditions allows us to help you manage any risks.

Pregnancy care plans will focus on maintaining thyroid levels within a target range and closely monitoring the health of both you and your baby.

Both too much (hyperthyroidism) and too little (hypothyroidism) of thyroid hormone can cause health issues during pregnancy.

Your MFM specialist will work with you to decide on a care plan that is specific to your needs. Your care plan may include any of the following:

Regular blood tests to monitor thyroid levels
Tracking symptoms of hypothyroidism or hyperthyroidism
Medications to regulate thyroid levels
Transitioning to medications that are safe or preferred during pregnancy (hyperthyroidism)
Thyroid surgery in some cases (for hyperthyroidism)
Newborn and postpartum monitoring

Labour and delivery

Our recommendations for your labour and delivery care may include some of the following:

Scheduling an induction of labour, if needed
Monitoring your blood sugar levels during labour and after the birth (when insulin requirements typically decrease)
Monitoring your baby’s blood sugar levels after birth, as needed
Monitoring your baby for signs of thyroid dysfunction after birth, as needed

It is important to follow up with your endocrinologist during the first few months postpartum to make any necessary adjustments to your medication. You will also be retested for your endocrine conditions to see if they remain after pregnancy.