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Graves' hyperthyroidism in pregnancy.

Caroline T Nguyen1, Jorge H Mestman

  • 1Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Current Opinion in Endocrinology, Diabetes, and Obesity
|August 8, 2019
PubMed
Summary
This summary is machine-generated.

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Managing Graves

Area of Science:

  • Endocrinology
  • Obstetrics
  • Neonatology

Background:

  • Graves' hyperthyroidism presents significant risks during pregnancy, affecting mother, fetus, and neonate.
  • Early identification and management are crucial for preventing adverse outcomes.

Purpose of the Study:

  • To review the management of Graves' hyperthyroidism in pregnancy.
  • To highlight the role of TSH-receptor antibodies (TRAb) in predicting fetal and neonatal risks.
  • To emphasize avoiding antithyroid drugs (ATDs) in early pregnancy due to malformation risks.

Main Methods:

  • Review of current literature on Graves' hyperthyroidism management during pregnancy.
  • Analysis of the role of TRAb in assessing disease activity and predicting complications.
  • Evaluation of ATD safety profiles in different pregnancy stages.

Related Experiment Videos

Main Results:

  • TRAb levels are key indicators of Graves' disease activity, relapse likelihood, and fetal/neonatal hyperthyroidism risk.
  • Both propylthiouracil (PTU) and methimazole (MMZ) show similar congenital malformation rates, but combined early exposure increases risk.
  • Avoiding ATDs in early pregnancy is recommended.

Conclusions:

  • Maintaining maternal euthyroidism is essential for a healthy pregnancy outcome.
  • Strategic use of TRAb and preconception counseling can minimize risks associated with Graves' hyperthyroidism and ATD use.
  • Physicians should prioritize preconception planning to optimize management and reduce ATD exposure during pregnancy.