Treatment is more complex for people with Graves’ disease who are pregnant because considerations need to be made for the thyroid function of both the mother and fetus. Antithyroid medications are the first line of treatment, and dosages are carefully adjusted to bring the mother’s thyroid hormone levels down to the upper limits of normal range (or slightly higher), without causing hypothyroidism in the developing fetus.[1] Radioactive iodine therapy is contraindicated during pregnancy because it can cause hypothyroidism in the fetus. Surgery may be considered if it is necessary for the mother’s health, but is not the first line of therapy. In cases in which surgery is warranted, it is generally delayed until the second trimester, when it poses less risk to the pregnancy.[2][3][1]
References
- ^Thyroid Disease in Pregnancy: ACOG Practice Bulletin, Number 223Obstet Gynecol.(2020 Jun)
- ^Brodsky JB, Cohen EN, Brown BW, Wu ML, Whitcher CSurgery during pregnancy and fetal outcome.Am J Obstet Gynecol.(1980-Dec-15)
- ^Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.Thyroid.(2017-Mar)