title: Important considerations in the management of Graves' disease in pregnant women.
abstract: Graves' disease is an autoimmune disorder in which autoantibodies to the thyroid-stimulating hormone receptor cause hyperthyroidism through unregulated stimulation of the thyroid-stimulating hormone receptor. Effective management of Graves' disease in pregnancy must address the competing fetal and maternal priorities of controlling hyperthyroidism in the mother on the one hand, and on the other, minimizing the impact of maternal disease and antithyroid drugs on the well-being of the fetus. Optimal strategies for achieving this intricate balance are currently a source of continued debate among thyroid experts and studies in recent decades are now providing greater clarity into the risk posed to the unborn baby by the combination of biochemical, immunological and pharmacological hazards arising from Graves' disease and its therapy. This review summarizes the current best practice and highlights important considerations and areas of uncertainty in the management of Graves' disease in pregnant women.
authors.affiliation: Endocrine and Diabetes Department, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, CF47 9DT, UK.
authors.forename: Onyebuchi E
authors.initials: OE
authors.lastname: Okosieme
authors.forename: John H
authors.initials: JH
authors.lastname: Lazarus
mesh_terms: D013956:Antithyroid Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001323:Autoantibodies / Q000276:immunology; D005260:Female; D005333:Fetus / Q000187:drug effects; D006111:Graves Disease / Q000628:therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*
chemical_list: D013956:Antithyroid Agents; D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating
keywords: Graves’ disease; TSH receptor antibody; antithyroid drugs; hyperthyroidism; pregnancy