Management of Hyperthyroidism in Pregnancy: Comparison of Recommendations of American Thyroid Association and Endocrine Society

Abstract

Appropriate diagnosis and treatment of hyperthyroidism during pregnancy are of outmost importance, because hyperthyroidism has major adverse impact on both mother and fetus. Since data on the management of thyroid dysfunction during pregnancy is rapidly evolving, two guidelines have been developed by the American Thyroid Association and the Endocrine society in the last 2 years. We compare here the recommendations of these two guidelines regarding management of hyperthyroidism during pregnancy. The comparison reveals no disagreement or controversy on the various aspects of diagnosis and treatment of hyperthyroidism during pregnancy between the two guidelines. Propylthiouracil has been considered as the first-line drug for treatment of hyperthyroidism in the first trimester of pregnancy. In the second trimester, consideration should be given to switching to methimazole for the rest of pregnancy. Methimazole is also the drug of choice in lactating hyperthyroid women.