Hyperthyroidism in pregnancy

  • Zainurrashid Z
  • Abd Al-Rhman HS
Keywords: Hyperthyroidism, pregnancy

Abstract

Summary                                                                         o Thyroid diseases are common in women, including at the time of pregnancies.

o Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis.

o Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality.

o Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis.

o Anti-thyroid drugs are safe and should be used with the lowest possible doses.

o Radioiodine treatment is contraindicated during pregnancy and lactation.

o Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects.

References

Woeber KA. Update on the management of hyperthyroidism and hypothyroidism. Arch Fam Med. 2000 Aug; 9(8):743-7.

Lim BH, Raman S, Sivanneratnam, Ngan A. Thyrotoxicosis in pregnancy – a six year review. Singapore Med J. 1989 Dec;30(6):539-41.

Nelson-Piercey C. Thyroid disease. Handbook of Obstetric Medicine, 2nd Edition. London: Martin Dunitz; 2001.

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. Number 37, August 2002. Thyroid disease in pregnancy. Obstet Gynecol. 2002 Aug;100(2):387-96.

Waltman PA, Brewer JM, Lobert S, et al. Thyroid storm in pregnancy. Crit Care Nurse. 2004 Apr;24(2):74-9.

Mujtaba Q, Burrow GN. Treatment of hyperthyroidism in pregnancy with PTU and methimazole. Obstet Gynaecol. 1975 Sep;46(3):282-5.

Bihan H, Vasquez MP, Krivitzky A, Cohen R. Aplasia cutis congenita and dysmorphic syndrome after antithyroid therapy during pregnancy. Endocrinologist. 2002;12(2):87-91.

Stulberg RA, Davies GA. Maternal thyrotoxicosis and fetal non-immune hydrops. Obstet Gynecol 2000 Jun;95(6 Pt 2):1036.

Lee A, Moretti ME, Collantes A, et al. Choice of breastfeeding and physicians’ advice. A cohort study of women receiving PTU. Pediatrics. 2000 Jul;106(1 Pt 1):27-30.

Miller RW, Zanzonico PB. Radioiodine fallout and breastfeeding. Radiat Res. 2005 Sep;164(3):339-40.

Practice Guidelines for Thyroid Disorders. Malaysian Endocrine and Metabolic Society of Malaysia. January 2000;16.

Gleicher N, Galbraith RM, Elkayam U. Principles and practice of medical therapy in pregnancy. 3rd ed. Norwalk, Conn: Appleton and Lange; 1998:436-41.

Published
2012-12-31
How to Cite
ZZ., & HSA. A.-R. (2012). Hyperthyroidism in pregnancy. Malaysian Family Physician, 13(3), 3. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/146
Section
Original Articles