Medical management of thyroid dysfunction in pregnancy and the postpartum.
BACKGROUND
Uncontrolled thyroid dysfunction in pregnancy is associated with adverse fetal and maternal outcomes.


OBJECTIVE
To review relevant literature and developments in the medical management of thyroid dysfunction in pregnancy.


RESULTS
Hyperthyroidism in pregnancy requires careful control of maternal disease whilst avoiding fetal hypothyroidism. Propylthiouracil is the preferred antithyroid drug in pregnancy although thiamazole can be used where propylthiouracil is unavailable. Synthetic levothyroxine is the treatment of choice in hypothyroidism. Patients with pre-existing hypothyroidism will generally require an increase in thyroxine dose in pregnancy. Most patients with postpartum thyroiditis will require treatment during the hypothyroid phase. Long-term follow-up of patients with this syndrome is essential owing to the risk of permanent hypothyroidism.


CONCLUSIONS
Excellent maternal and fetal outcomes can be achieved with appropriate management of thyroid dysfunction in pregnancy.
Okosieme
Onyebuchi E
OE
Prince Charles Hospital, Department of Endocrinology and Diabetes, Cwm Taff NHS Trust Merthyr Tydfil, Mid Glamorgan CF479DT, UK. buchiokosieme@hotmail.com
Marx
Helen
H
Lazarus
John H
JH
D013956:Antithyroid Agents / Q000627:therapeutic use; D001942:Breast Feeding; D005260:Female; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy* / Q000503:physiopathology; D007037:Hypothyroidism / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000503:physiopathology; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000188:drug therapy / Q000503:physiopathology; D013961:Thyroid Gland / Q000503:physiopathology; D013963:Thyroid Hormones / Q000627:therapeutic use
D013956:Antithyroid Agents; D013963:Thyroid Hormones