Abstract | INTRODUCTION: Poorly treated or untreated maternal overt hyperthyroidism may affect pregnancy outcome. Fetal and neonatal hypo- or hyper-thyroidism and neonatal central hypothyroidism may complicate health issues during intrauterine and neonatal periods. AIM: To review articles related to appropriate management of hyperthyroidism during pregnancy and lactation. METHODS: RESULTS:
Antithyroid drugs are the main therapy for maternal hyperthyroidism. Both methimazole (MMI) and propylthiouracil (PTU) may be used during pregnancy; however, PTU is preferred in the first trimester and should be replaced by MMI after this trimester. Choanal and esophageal atresia of fetus in MMI-treated and maternal hepatotoxicity in PTU-treated pregnancies are of utmost concern. Maintaining free thyroxine concentration in the upper one-third of each trimester-specific reference interval denotes success of therapy. MMI is the mainstay of the treatment of post partum hyperthyroidism, in particular during lactation. CONCLUSION: Management of hyperthyroidism during pregnancy and lactation requires special considerations and should be carefully implemented to avoid any adverse effects on the mother, fetus, and neonate.
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Authors | Fereidoun Azizi, Atieh Amouzegar |
Journal | European journal of endocrinology
(Eur J Endocrinol)
Vol. 164
Issue 6
Pg. 871-6
(Jun 2011)
ISSN: 1479-683X [Electronic] England |
PMID | 21389085
(Publication Type: Journal Article, Meta-Analysis, Review)
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Chemical References |
- Antithyroid Agents
- Methimazole
- Propylthiouracil
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Topics |
- Adult
- Antithyroid Agents
(adverse effects, pharmacokinetics, therapeutic use)
- Child Development
(drug effects)
- Female
- Gestational Age
- Humans
- Hyperthyroidism
(congenital, drug therapy)
- Infant, Low Birth Weight
- Infant, Newborn
- Lactation
- Maternal-Fetal Exchange
- Methimazole
(adverse effects, pharmacokinetics, therapeutic use)
- Postpartum Thyroiditis
(drug therapy)
- Pregnancy
- Pregnancy Complications
(drug therapy)
- Propylthiouracil
(adverse effects, pharmacokinetics, therapeutic use)
- Risk
- Thyroid Function Tests
- Thyroid Gland
(drug effects, embryology)
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