1. Pre-conception and pregnancy counseling It is recommended that women diagnosed with hyperthyroidism should first be treated for hyperthyroidism and try to wait for a period of time before pregnancy after they are cured. For pregnant women with stable hyperthyroidism who are pregnant and are not planning to have an abortion, it is recommended to use drugs that are not teratogenic and have less risk of passing through the placenta, such as PTU. 131 iodine diagnosis and treatment are not recommended. If 131 iodine treatment is applied before pregnancy, pregnancy should be carried out only after six months of contraception. Pregnant women are currently in hypothyroidism and undergoing thyroid hormone supplementation treatment. Thyroid hormone has no effect on the baby and cannot be discontinued after pregnancy, as discontinuation of the medication may cause miscarriage. 2. Fetal monitoring and prenatal care during pregnancy Pregnant women with hyperthyroidism cannot provide sufficient nutrition for the fetus, which affects the growth and development of the fetus, and is prone to fetal growth restriction (FGR) and low birth weight. Checkup: Pay attention to the growth of mother’s weight, uterine height and abdominal circumference, and have fetal ultrasound examination and fetal weight estimation every one to two months. Enhance nutrition and rest, and take the left side position. If FGR is detected, hospitalization should be promptly. Pregnant women with hyperthyroidism taking ATD may cause fetal hypothyroidism: fetal goiter, slow weight gain, slow fetal heart rate of 110~120 beats/min, reduced fetal movement, low amniotic fluid. In congenitally hypothyroid fetuses, the prognosis may be poor. There is little experience on how to treat the fetus, but it is suggested that umbilical cord puncture is feasible and cord blood is taken to check the thyroid function in order to confirm the diagnosis. Pregnant women with hyperthyroidism are prone to preterm delivery. In case of preterm labor, the fetus should be actively preserved, avoiding β-receptor stimulants during treatment, bed rest as much as possible, and using fetal preservation drugs such as magnesium sulfate, Turinal, and procaine. Pregnant women with hyperthyroidism are prone to complications of gestational hyperemesis in the late stage. Pay attention to early calcium supplementation, low-salt diet and nutritional guidance. Pay attention to maternal examination: weight change, edema, urine protein and elevated blood pressure. In late pregnancy, 37~38 weeks, you should be admitted to the hospital for observation. Perform weekly fetal heart monitoring, pay attention to fetal distress, and perform electrocardiogram for pregnant women to understand whether there is heart damage and echocardiogram if necessary. 3, labor and delivery Ultrasound to observe the size of the fetal thyroid gland and whether there is enlargement of the thyroid gland, resulting in overstretching of the fetal head. If there is any abnormality, it may cause obstructed labor and consider cesarean delivery. In addition to obstetric factors, vaginal delivery is usually possible and most of the deliveries go smoothly. In pregnant women with hyperthyroidism, the contractions are usually strong, the fetus is small, and the labor is relatively short. The rate of neonatal asphyxia has been reported to be high. During labor, energy should be supplemented, food should be encouraged, appropriate fluids should be given, oxygen and fetal heart monitoring should be given throughout the labor, blood pressure, pulse and body temperature should be measured once in q2~4h, and psychological care should be paid attention to the labor process. If the mother has cardiac insufficiency, the labor is not progressing smoothly, there is fetal malposition, fetal head extension, fetal head cannot enter the disc, etc., the indication for cesarean section can be relaxed. Postpartum antibiotics are given to prevent infection. The pediatrician should be present at the birth of the newborn, prepare for neonatal resuscitation, and keep the umbilical cord blood to check the nail function. After the birth of the newborn, pay special attention to the signs and symptoms of hypo- or hyperthyroidism. Hypothyroidism in newborns: large tongue, frog’s belly, florid skin, temperature not rising, poor response, low tone, little food, delayed defecation, weight not growing; individual has immature lungs, pulmonary hyaline membrane disease. Neonatal hyperthyroidism (rare): Occurs a few days after delivery (5-10 days), manifestations include: small head, enlarged thyroid gland, both eyes protruding or open, gleaming, high skin temperature, in severe hyperthyroidism accompanied by hyperthermia, accelerated heart rate whistling and other hyperthyroid crisis manifestations. There are also symptoms of hyperthyroidism such as crying, heavy milk intake, frequent stools and lack of weight gain. Therefore, it is recommended to extend the hospital stay of newborns for observation, and to ask family members to come to the hospital for examination and follow-up if there is any abnormality after discharge. PTU (Propylthiouracil) is better than MMI (Tabazol), if the mother takes PTU 200mg, tid, the newborn gets PTU 99μg daily, so it is safe for the mother to take PTU for the baby.