What to do about hyperthyroidism in pregnant women

  The treatment of hyperthyroidism during pregnancy is special and can cause certain harm to both the pregnant woman and the fetus, so the treatment of hyperthyroidism during pregnancy has its special characteristics compared to the treatment of general hyperthyroidism, and the treatment mainly includes the following aspects: 1. Anti-thyroid medication: It is the first choice of treatment for hyperthyroidism during pregnancy. propylthiouracil is preferred during T1 (1~3 months), and methimazole is preferred during T2 (4~6 months) and T3 (7~9 months). The dosage of medication should be small.  2. Surgical treatment: Pregnancy is a relative contraindication to surgical treatment because surgery can cause premature birth and miscarriage, and anesthetics can be teratogenic. If hyperthyroidism is not controlled by antithyroid medication, surgical treatment can be chosen during the T2 stage of pregnancy.  3. Antithyroid drug therapy during lactation: methimazole is preferred and the dosage should be small.  4. 131I therapy is contraindicated during pregnancy.  5. Neonatal hyperthyroidism: maternal thyroid hormone receptor stimulating antibodies (TSAb) can stimulate the fetal thyroid through the placenta causing fetal or neonatal hyperthyroidism. Monitoring thyroid hormone receptor stimulating antibodies from 20 to 24 weeks of gestation is especially important, and if positive, hyperthyroidism monitoring needs to be implemented in the fetus and neonate.  Therefore, patients with hyperthyroidism during pregnancy and continuing pregnancy are, in principle, treated with anti-thyroid medication and surgical treatment in mid-pregnancy. It is also important to have regular maternity checkups and pay attention to the effects on the mother and fetus.