Graves’ Hyperthyroidism Management and Pregnancy

Can we revise Treatment Actions for Management of Graves' Hyperthyroidism in pregnancy?
Graves’ disease is usually treated with antithyroid agents throughout the pregnancy condition. Latest Danish research showed that children born from 1996 to 2008, which are almost 817,093 children, were treated with antithyroid medication.
Study also reveals that both commonly used antithyroid medications including, Methimazole and Propylthiouracil were highly associated with birth defects. According to these recent research findings, physicians should discuss with their pregnant patients about hyperthyroidism’s two important aspects of future pregnancies.

  • Patients should avoid pregnancy until the Graves’ disease is diagnosed and properly treated.
  • Patients should be very careful as the risk of congenital malformation resulting from antithyroid drug exposure could be in first trimester.

My strategy has always been to treat Graves’ disease prior to pregnancy, utilizing radioactive iodine treatment or in some cases surgery. This is not a prevalent position for me to take; however in light of this research, it seems appropriate in review.

Dr. Shahzad Ahmad, MD, FACE, ECNU

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