title: Medical management of thyroid dysfunction in pregnancy and the postpartum.
abstract: 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.
authors: Prince Charles Hospital, Department of Endocrinology and Diabetes, Cwm Taff NHS Trust Merthyr Tydfil, Mid Glamorgan CF479DT, UK. buchiokosieme@hotmail.com
authors: Onyebuchi E
authors: OE
authors: Okosieme
authors: Helen
authors: H
authors: Marx
authors: John H
authors: JH
authors: Lazarus
mesh_terms: 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
chemical_list: D013956:Antithyroid Agents; D013963:Thyroid Hormones