Hyperthyroidism in Pregnancy: The Delicate Balance between Too Much or Too Little Antithyroid Drug

Overt hyperthyroidism (HT) during pregnancy is associated with a risk of maternal–fetal complications. Antithyroid drugs (ATD) have a potential risk for teratogenic effects and fetal–neonatal hypothyroidism. This study evaluated ATD treatment and thyroid function control during pregnancy, and pregna...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-08, Vol.10 (16), p.3742
Main Authors: Gheorghiu, Monica Livia, Bors, Roxana Georgiana, Gheorghisan-Galateanu, Ancuta-Augustina, Pop, Anca Lucia, Cretoiu, Dragos, Varlas, Valentin Nicolae
Format: Article
Language:English
Subjects:
Birth defects
Clinical medicine
Drug dosages
Drug withdrawal
Fetuses
Goiter
Hormones
Hyperthyroidism
Pregnancy
Prenatal exposure
Remission (Medicine)
Standard deviation
Thyroid gland
Womens health
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Summary:Overt hyperthyroidism (HT) during pregnancy is associated with a risk of maternal–fetal complications. Antithyroid drugs (ATD) have a potential risk for teratogenic effects and fetal–neonatal hypothyroidism. This study evaluated ATD treatment and thyroid function control during pregnancy, and pregnancy outcome in women with HT. Patients and methods: A retrospective analysis of 36 single fetus pregnancies in 29 consecutive women (median age 30.3 ± 4.7 years) with HT diagnosed before or during pregnancy; a control group of 39 healthy euthyroid pregnant women was used. Results: Twenty-six women had Graves’ disease (GD, 33 pregnancies), 1 had a hyperfunctioning autonomous nodule, and 2 had gestational transient thyrotoxicosis (GTT). Methimazole (MMI) was administered in 22 pregnancies (78.5%), Propylthiouracil (PTU) in 2 (7.1%), switch from MMI to PTU in 4 (14.2%), no treatment in 8 pregnancies (3 with subclinical HT, 5 euthyroid with previous GD remission before conception). In the 8 pregnancies of GD patients diagnosed during gestation or shortly before (
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10163742