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Clin Diabetes Endocrinol. 2018 Mar 1;4:4. doi: 10.1186/s40842-018-0054-7. eCollection 2018.

Graves' hyperthyroidism in pregnancy: a clinical review.

Author information

1
1Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Keck School of Medicine, University of Southern California, 1540 Alcazar Street, CHP 204, Los Angeles, Ca 90033 USA.
2
2Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2020 Zonal Avenue, IRD 220, Los Angeles, CA 90033 USA.
3
3Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, Ca 90033 USA.
4
4Division of Endocrinology, Diabetes & Metabolism, Department of Medicine and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 1540 Alcazar Street CHP 204, Los Angeles, California 90033 USA.

Abstract

Background:

Graves' hyperthyroidism affects 0.2% of pregnant women. Establishing the correct diagnosis and effectively managing Graves' hyperthyroidism in pregnancy remains a challenge for physicians.

Main:

The goal of this paper is to review the diagnosis and management of Graves' hyperthyroidism in pregnancy. The paper will discuss preconception counseling, etiologies of hyperthyroidism, thyroid function testing, pregnancy-related complications, maternal management, including thyroid storm, anti-thyroid drugs and the complications for mother and fetus, fetal and neonatal thyroid function, neonatal management, and maternal post-partum management.

Conclusion:

Establishing the diagnosis of Graves' hyperthyroidism early, maintaining euthyroidism, and achieving a serum total T4 in the upper limit of normal throughout pregnancy is key to reducing the risk of maternal, fetal, and newborn complications. The key to a successful pregnancy begins with preconception counseling.

KEYWORDS:

Antithyroid drugs; Hyperthyroidism; Methimazole; Neonatal hyperthyroidism; Pregnancy; Propylthiouracil; TRAb; Thyroid storm

Conflict of interest statement

N/AN/AThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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