Therapy of Hyperthyroidism in Pregnancy and Breastfeeding

@article{Fumarola2011TherapyOH,
  title={Therapy of Hyperthyroidism in Pregnancy and Breastfeeding},
  author={Angela Fumarola and Agnese Di Fiore and Michela Dainelli and Giorgio Grani and Giovanni Carbotta and A. Calvanese},
  journal={Obstetrical \& Gynecological Survey},
  year={2011},
  volume={66},
  pages={378-385}
}
Uncontrolled hyperthyroidism in pregnancy is associated with an increased risk of perinatal complications. The state of the art discussed here has been derived through a wide MEDLINE search throughout English-language literature by using a combination of words such as hyperthyroidism, propylthiouracil (PTU), methimazole, rituximab, and pregnancy to identify original related works and review articles. Thioamides are the main first-line therapeutic options, whereas beta-blockers and iodine are… Expand
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TLDR
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TLDR
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New-onset Graves' disease in the postpartum period.
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  • Journal of midwifery & women's health
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Effect of Thyromimetic GC-1 Selective Signaling on Reproductive and Lactational Performance in the Hypothyroid Rat
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TLDR
Preconception counseling and a multifaceted approach to care by the endocrinologist and the obstetric team are imperative for a successful pregnancy in women with Graves hyperthyroidism. Expand
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Survey responses indicate that routine pregnancy testing prior to radioiodine therapy for patients in the child-bearing age is not yet a standard procedure and it should be. Expand
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The possibility of pregnancy should be considered in all fertile women before therapy with radionuclides or cytostatic regimens, and a clinical investigation undertaken on wide indications with determination of serum β-hCG, preferably together with an ultrasound examination. Expand
Pregnancy outcome, thyroid dysfunction and fetal goitre after in utero exposure to propylthiouracil: a controlled cohort study.
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PTU does not seem to be a major human teratogen, however, it could cause fetal/neonatal hypothyroidism with or without goitre, and Fetal thyroid size monitoring and neonatal thyroid function tests are important for appropriate prevention and treatment. Expand
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TLDR
Methimazole and propylthiouracil are the main antithyroid drugs used for hyperthyroidism and Rituximab, a monoclonal antibody directed against human CD20, was recently proposed as a biological therapy for cases of Graves' disease unresponsive to traditional drugs. Expand
Management of Graves' hyperthyroidism in pregnancy: focus on both maternal and foetal thyroid function, and caution against surgical thyroidectomy in pregnancy.
TLDR
Antithyroid drug therapy of pregnant women with Graves' hyperthyroidism should be balanced to control both maternal and foetal thyroid function. Expand
Propylthiouracil Versus Methimazole in Treatment of Graves' Disease During Pregnancy
TLDR
PTU should still be considered as the first-line agent in the treatment of Graves' disease during pregnancy, and methimazole should be considered a viable second choice if the patient is intolerant toPTU, has an allergic reaction to PTU, or fails to become euthyroid while receiving PTU. Expand
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TLDR
Little relationship was observed between maternal doses and fetal thyroid status; in fact, when low doses of both PTU and MMI were administered, high TSH levels in the fetus were observed in 7 of the 34 fetuses and in 6 of the 43 fetuses, respectively. Expand
Pharmacologic treatment of hyperthyroidism during lactation.
TLDR
Women with hyperthyroidism using methimazole or propylthiouracil should not be discouraged from breastfeeding, as the benefits of breastfeeding largely outweigh the theoretical minimal risks. Expand
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TLDR
Graves' disease is aggravated in early pregnancy and after delivery and ameliorates in the latter half of pregnancy, and postpartum relapse of persistent hyperthyroidism could be predicted from an early increase in the FT4 index during pregnancy. Expand
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