Hyperthyroidism, pregnancy, antithyroid drugs, methimazole. Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications methimazole and propylthiouracil, radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Effect of treatment of maternal subclinical hypothyroidism or hypothyroxinemia on iq in offspring. Graves hyperthyroidism in pregnancy clinical diabetes and. According to recent guidelines, the measurement of the tsh receptor antibodies is not required, if antithyroid drugs have been used because the maternal thyroid. Its generally considered safe, and it is used to treat more than 70% of adults with hyperthyroidism. Diagnosis and treatment of hypothyroidism in pregnancy. Radioactive iodine ablation is the most widely used treatment in the united states. Management of hyperthyroidism during pregnancy and lactation. Thyroid disease in pregnancy american family physician. There are several important issues to be considered when hyperthyroidism occurs during pregnancy.
Treatment goal of therapy is control without causing fetal or neonatal hypothyroidism keep free t4 in highnormal range or total t4 at 1. Management of thyroid dysfunction during pregnancy and postpartum. Hypothyroidism can occur during pregnancy due to the initial presentation of hashimotos thyroiditis, inadequate treatment of a woman already known to have hypothyroidism from a variety of causes, or overtreatment of a hyperthyroid woman with antithyroid medications. Hypothyroidism in pregnancy american thyroid association. High levels of thyroid hormones in your body can be toxic. Studies have recently questioned the optimal treatment of hyperthyroidism during pregnancy. The most common cause of hyperthyroidism during pregnancy is graves disease. Guidelines for tshreceptor antibody measurements in preg. Thyroid diseases affect up to 5% of all pregnancies. Both of these drugs cross the placenta and can potentially impair the babys thyroid function and cause fetal goiter. Due to the physiologic changes in pregnancy, special consideration must be given in accurately diagnosing, monitoring, and treating pregnant patients with hyperthyroidism. Methimazole tapazole or propylthiouracil ptu are the atds available in the united states for the treatment of hyperthyroidism see hyperthyroidism brochure. Treatment is necessary if you have hyperthyroidism. Treatment options for graves disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation.
Maternal hyperthyroidism is a relative rare disorder, which can seriously complicate pregnancy in each of its periods. Hyperthyroidism and pregnancy endocrinologia y nutricion. Hyperthyroidism during pregnancy is uncommon and has been. Graves disease is a complex autoimmune disorder, characterized by autoantibodies that activate the tsh receptor. The treatment of pregnant women with hyperthyroidism parallels that of. Laurberg p, lazarus jh, mandel sj, peeters rp, sullivan s. Hyperthyroidism in pregnancy brochure pdf american thyroid. Diagnosis and treatment of hyperthyroidism in pregnancy.
Adverse pregnancy and neonatal outcomes are increased by maternal thyroid disease and adequate treatment is. Guidelines of the american thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Doctors have used radioactive iodine to treat hyperthyroidism for over 60 years. Outline treatment of hyperthyroidism during pregnancy. Radioiodine treatment of hyperthyroidism in a pregnant woman article pdf available in journal of nuclear medicine 392. Hyperthyroidism in pregnancy american thyroid association.