Management of Hyperthyroidism in Pregnancy: Diagnosis and Treatment Options

Diagnosis and treatment of hyperthyroidism in pregnancy involves consideration of clinical manifestations, establishing the cause (such as Graves Disease or hCG mediated hyperthyroidism), and determining the need for treatment based on the severity of symptoms. Therapeutic options include medications like Propylthiouracil and Methimazole, as well as surgical interventions or radioiodine therapy when necessary. Management aims to address symptomatic and moderate to severe cases to ensure the health of both the mother and the fetus.

• Hyperthyroidism
• Pregnancy
• Diagnosis
• Treatment
• Graves Disease

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1. . Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

2. Hyperthyroidism in Pregnancy Diagnosis is based upon: Pregnancy Complication: Clinical Manifestation Spontaneous Abortion Premature Labor LBW Stillbirth Preeclampsia Heart Failure Overt Hyperthyroidism -Subclinical Hyperthyroidism? Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

3. Establishing the cause Graves Disease Clinical Findings Lab Tests Imaging Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

4. Establishing the cause: hCG mediated Hyperthy. Gestational Transient Thyrotoxicosis Hyperemesis Gravidarum Trophoblastic Hyperthy. Familial Gestational Hyperthy. Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

5. No Need for Treatment Transient subclinical hyperthy. (1st trim) hCG mediated/overt hyperth.(Transient, Mild)* Hyperemesis Gravidarum Hyperthy. Mild or asymptomatic( Subclinical or Overt)* Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

6. Who needs treatment? Goal? Symptomatic and/or moderate to sever Overt Hyperthy. Due to: Graves d. Toxic Adenoma Toxic multinodular goiter GTN prior to surgery Therapeutic Options: Thionamides Beta Blockers Thyroidectomy Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

7. Suggestion for treatment: Propylthiouracil (PTU) in 1st Trim. Methimazole in 2nd & 3rd Trim. Or PTU Initial Dosing Surgical management Radioiodine therapy Dr. SIMIN TAGHAVI TBZ MED U. MFM U.

8. Fetus and Graves Dis. Nursing Mother and Treatment Dr. SIMIN TAGHAVI TBZ MED U. MFM U.