Graves' hyperthyroidism in pregnancy: a clinical review

Area of Science:

• Endocrinology
• Obstetrics and Gynecology

Background:

• Graves' hyperthyroidism impacts approximately 0.2% of pregnant individuals.
• Accurate diagnosis and effective management of Graves' hyperthyroidism during pregnancy present ongoing challenges for clinicians.

Purpose of the Study:

• To provide a comprehensive review of the diagnosis and management strategies for Graves' hyperthyroidism in pregnant women.
• To discuss critical aspects including preconception counseling, etiologies of hyperthyroidism, thyroid function testing, and pregnancy-related complications.
• To cover maternal management, thyroid storm, anti-thyroid drugs, fetal and neonatal implications, and postpartum care.

Main Methods:

• Literature review of existing studies and clinical guidelines on Graves' hyperthyroidism in pregnancy.
• Synthesis of information regarding diagnostic approaches and therapeutic interventions.
• Analysis of maternal and fetal outcomes associated with different management strategies.

Main Results:

• Early diagnosis of Graves' hyperthyroidism is crucial for optimal outcomes.
• Maintaining euthyroid status throughout pregnancy is essential for reducing risks.
• Achieving serum total T4 levels within the upper limit of normal is associated with better maternal and fetal health.

Conclusions:

• Early diagnosis and proactive management are key to minimizing maternal, fetal, and neonatal complications.
• Maintaining maternal euthyroidism and appropriate thyroid hormone levels throughout pregnancy is paramount.
• Comprehensive preconception counseling is fundamental for a successful pregnancy in women with Graves' hyperthyroidism.