Hyperthyroidism and Its Implications for Diagnosis and Management of Complications During Pregnancy
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Thyroid dysfunction alters the physiological events of pregnancy that may have serious outcomes if left untreated. Hyperthyroidism (a thyroid disease) is related to complications during pregnancy. A challenging task for the physician is to correctly diagnose and properly manage hyperthyroidism in pregnant women. Hyperthyroidism is an autoimmune disease caused by excessive production of thyroxin hormone. The objective of this paper is to review the research in detection and management of Graves’ disease (thyrotoxicosis) during and after pregnancy. This paper discusses thyroid receptor antibodies, etiology of Grave’s disease (thyrotoxicosis), pregnancy related complications, infants’ thyrotoxicosis management, as well as post-partum management, guidelines and counseling offered to pregnant women. Literature search was conducted using the keyword ‘hyperthyroidism’ in conjunction with pregnancy, anti-thyroid drugs and birth defects in Pubmed, Google Scholar and Medline. Maintaining thyroid gland may reduce the complications of pregnancy. At the beginning of pregnancy, low doses of anti-thyroid drugs are usually recommended to women by endocrinologists. However, the use of these drugs is completely stopped after 4 – 8 weeks of gestation. Propylthiouracil is the preferred anti-thyroid drug used in the first trimester in case of preconception to decrease the risk of teratogenicity. Carbimazole may be used in the first three months. Early diagnosis and maintaining normal hormone concentration by reducing the level of thyroid receptor antibodies as well as anti-thyroid drugs is essential in order to prevent maternal and fetal complications. Counseling and guidelines provided by endocrinologists constitute the key to a healthy and successful pregnancy.
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