[Diagnosis and treatment of autoimmune thyroid disease (ATD) complicated by pregnancy]

During pregnancy, distinguishing TBII-negative Graves' disease from HCG-related thyrotoxicosis is important. There has been no convincing evidence for any adverse effects of maternal hyper- or hypothyroidism, or thionamides transferred from the mother on fetal organogenesis. In Graves' disease, maintaining maternal free T4 within normal range with thionamides may be preferable to fetal euthyroidism when toxemia of pregnancy or glucose intolerance develops, since there is little evidence indicating fetal hypothyroidism due to maternal ingestion of thionamides can cause intellectual retardation. TBII and/or TSAb levels should be determined by the 3rd trimester in patients with a history of ablative therapy for Graves' disease, and in patients with primary myxedema, in order to predict or treat fetal hyper- and hypothyroidism.