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196378

MANAGEMENT OF THYROTOXICOSIS IN PREGNANCY

Article

Last updated: 24 Dec 2024

Subjects

-

Tags

Surgery

Abstract

Background: Autoimmune GD (Graves' Disease) is the most common cause of hyperthyroidism in women of childbearing age. To prevent maternal and fetal complications, thyrotoxicosis during pregnancy should be adequately managed and controlled. The physiological adaptations associated with pregnancy challenge the assessment of thyroid function in pregnant women, and the treatment with antithyroid drugs (ATD) raises concerns for the pregnant woman and the fetus. Our aim of this study was to discuss the effect of hyperthyroidism on pregnancy, different methods of diagnosis of hyperthyroidism and treatment of hyperthyroidism during pregnancy for a favorable maternal health and fetal outcome. Objective: To discuss thyrotoxicosis this affects the pregnant woman and the effect of hyperthyroidism on pregnancy. It is to discuss different methods of diagnosis of hyperthyroidism during pregnancy. Also it is to study the treatment of hyperthyroidism and thyrotoxicosis during pregnancy for a favorable maternal health and fetal outcome. Patients and Methods: A prospective randomized clinical study that was conducted on 20 pregnant female patients with thyrotoxicosis in different stages of pregnancy attending Bab-El Shaaria and El-Hussein University Hospitals through the period from April (2020) to December (2020). The selected patients received one of the two main medications which are propyl-thiouracil (PTU) and methimazole (MMI). Propylthiouracil was given in the 1st trimester and Methimazole was given in 2nd and 3rd trimester. Results: There was statistically significant difference found between pretreatment and post treatment groups regarding Heat Intolerance, Palpitations, Tremors, and Irritability, while there was no statistically significant difference found between Pretreatment and Post treatment regarding Exophthalmos. Methimazole (MMI) is preferred to propyl-thiouracil (PTU) after the first trimester because PTU has an association with hepatotoxicity. However, PTU is recommended for the first trimester of pregnancy because its teratogenic effects are considered less severe than those of MMI. Conclusion: Management of hyperthyroidism during pregnancy and lactation requires special considerations and should be meticulously implemented to provide best care to pregnant woman and prevent any adverse effects. Thyrotoxicosis of pregnancy can present unique diagnostic challenges and, if untreated, is associated with increased risks of adverse maternal, fetal, and neonatal complications. The clinical presentation, serum thyroid function test results, and serum TRAb titers can help differentiate the etiology of thyrotoxicosis. However, assessment and monitoring with serum thyroid function tests can be difficult, as there is significant overlap between test results arising from normal pregnancy physiology and intrinsic hyperthyroidism.

DOI

10.21608/amj.2021.196378

Keywords

Graves' disease, Antithyroid drugs, thyrotoxicosis

Authors

First Name

Waleed

Last Name

Abd El-Monem Mansour

MiddleName

-

Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

Email

waleed.mans_89@hotmail.com

City

-

Orcid

-

First Name

Mohamed

Last Name

Sobhy Teamma

MiddleName

-

Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

First Name

Osama

Last Name

Fathy Ibrahim Al-Mezaien

MiddleName

-

Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

First Name

Ahmed

Last Name

Mohamed Mohamed Saeed

MiddleName

-

Affiliation

Departments of Gynaecology & Obstetrics, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

Volume

50

Article Issue

4

Related Issue

27826

Issue Date

2021-10-01

Receive Date

2021-09-27

Publish Date

2021-10-01

Page Start

2,401

Page End

2,412

Print ISSN

1110-0400

Link

https://amj.journals.ekb.eg/article_196378.html

Detail API

https://amj.journals.ekb.eg/service?article_code=196378

Order

5

Type

Original Article

Type Code

941

Publication Type

Journal

Publication Title

Al-Azhar Medical Journal

Publication Link

https://amj.journals.ekb.eg/

MainTitle

MANAGEMENT OF THYROTOXICOSIS IN PREGNANCY

Details

Type

Article

Created At

22 Jan 2023