Interventions for preventing and treating hyperthyroidism in pregnancy.
BACKGROUND
Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption.


OBJECTIVE
To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 July 2010).


METHODS
We intended to include randomised controlled trials comparing antithyroid treatments in pregnant women with hyperthyroidism.


METHODS
Two review authors would have assessed trial eligibility and risk of bias, and extracted data.


RESULTS
No trials were located.


CONCLUSIONS
As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid drugs for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil.
Earl
Rachel
R
Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Medical School North Building, Frome Road, Adelaide, Australia, 5005.
Crowther
Caroline A
CA
Middleton
Philippa
P
D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000517:prevention & control / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
Lancet Oncol. 2005 Jan;6(1):59-61
15629277
Endocrinol Metab Clin North Am. 2006 Mar;35(1):117-36, vii
16310645
J Clin Endocrinol Metab. 2007 Aug;92(8 Suppl):S1-47
17948378
Best Pract Res Clin Endocrinol Metab. 2004 Jun;18(2):267-88
15157840
Am J Obstet Gynecol. 2004 Jan;190(1):211-7
14749662
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003420
15846664
Eur J Pediatr. 1992 Aug;151(8):558-9
1505570
N Engl J Med. 2005 Mar 3;352(9):905-17
15745981
Pediatrics. 2001 Sep;108(3):776-89
11533352
BMJ. 2008 Mar 22;336(7645):663-7
18356235
Best Pract Res Clin Endocrinol Metab. 2004 Jun;18(2):289-302
15157841
J Endocrinol Invest. 2002 Jul-Aug;25(7):586-9
12150331
J Clin Endocrinol Metab. 2009 Jun;94(6):1881-2
19401361