Treatment of hyperthyroidism during pregnancy

  1. ATD treatment: ATD treatment can be given throughout pregnancy. Because ATD can affect fetal thyroid function through the placenta, it is important to closely monitor the thyroid hormone levels of pregnant women to determine the dose of ATD needed for treatment. PTU is preferred because it does not easily cross the placenta, and an initial dose of PTU at 300 mcg/d and a constant dose of 50-150/D is safe for the fetus. Serum FT4 should be maintained at the upper limit of normal values. In addition, the dose of ATD can be reduced in the second trimester of pregnancy due to the immunosuppressive effects of pregnancy. After delivery, the immunosuppression is lifted. Hyperthyroidism is easy to recur and the need for ATD increases.  2.Surgical treatment: For hyperthyroidism occurring in pregnancy, after controlling the symptoms of hyperthyroidism by propylthiouracil treatment, subtotal thyroidectomy can be chosen in the middle of pregnancy.  3.ATD treatment during lactation: Because the proportion of propylthioxypyrimethamine passing through the placenta and entering breast milk is less than that of MMI treatment; therefore, propylthioxypyrimethamine is preferred, and it is generally considered that propylthioxypyrimethamine 300 mg is safe for infants.  4. Combining ATD treatment with eugenol: it cannot prevent the occurrence of fetal hypothyroidism because the amount of the latter passing through the placenta is less.  5. Maternal TSAB can cause neonatal hyperthyroidism through the placenta. Mild cases are self-limiting and do not require treatment, while severe cases can be given PTU 10-25 mg. 1 dose every 8 hours.