Graves' hyperthyroidism in pregnancy: a clinical review

Clin Diabetes Endocrinol. 2018 Mar 1;4:4. doi: 10.1186/s40842-018-0054-7. eCollection 2018.

Abstract

Background: Graves' hyperthyroidism affects 0.2% of pregnant women. Establishing the correct diagnosis and effectively managing Graves' hyperthyroidism in pregnancy remains a challenge for physicians.

Main: The goal of this paper is to review the diagnosis and management of Graves' hyperthyroidism in pregnancy. The paper will discuss preconception counseling, etiologies of hyperthyroidism, thyroid function testing, pregnancy-related complications, maternal management, including thyroid storm, anti-thyroid drugs and the complications for mother and fetus, fetal and neonatal thyroid function, neonatal management, and maternal post-partum management.

Conclusion: Establishing the diagnosis of Graves' hyperthyroidism early, maintaining euthyroidism, and achieving a serum total T4 in the upper limit of normal throughout pregnancy is key to reducing the risk of maternal, fetal, and newborn complications. The key to a successful pregnancy begins with preconception counseling.

Keywords: Antithyroid drugs; Hyperthyroidism; Methimazole; Neonatal hyperthyroidism; Pregnancy; Propylthiouracil; TRAb; Thyroid storm.

Publication types

  • Review