Therapy of Hyperthyroidism in Pregnancy and Breastfeeding
| Autor: | Giorgio Grani, Angela Fumarola, Agnese Di Fiore, A. Calvanese, Giovanni Carbotta, Michela Dainelli |
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| Rok vydání: | 2011 |
| Předmět: |
Postnatal Care
endocrine system medicine.medical_specialty endocrine system diseases Adrenergic beta-Antagonists MEDLINE Breastfeeding Hyperthyroidism Pregnancy medicine Humans Obstetrics Perinatal complications business.industry Obstetrics and Gynecology General Medicine medicine.disease Pregnancy Complications Thioamides Breast Feeding Increased risk Female Thyroid Crisis business Breast feeding hormones hormone substitutes and hormone antagonists Iodine |
| Zdroj: | Obstetrical & Gynecological Survey. 66:378-385 |
| ISSN: | 0029-7828 |
| DOI: | 10.1097/ogx.0b013e31822c6388 |
| Popis: | Uncontrolled hyperthyroidism in pregnancy is associated with an increased risk of perinatal complications. The state of the art discussed here has been derived through a wide MEDLINE search throughout English-language literature by using a combination of words such as hyperthyroidism, propylthiouracil (PTU), methimazole, rituximab, and pregnancy to identify original related works and review articles. Thioamides are the main first-line therapeutic options, whereas beta-blockers and iodine are second-choice drugs; surgery is resorted to only in exceptional cases. Methimazole and PTU reduce the production of thyroid hormones by selectively inhibiting thyroid peroxidase. PTU was once considered to be the first-choice drug in the treatment of gestational hyperthyroidism; however, the United States Food and Drug Administration now recommends it as a second-line thioamide, which should be used solely by women in their first trimester of pregnancy. Thyroidectomy is to be carried out only in pregnant women affected by life-threatening, uncontrollable hyperthyroidism, or in cases with thioamide intolerance.ObstetriciansGynecologists, Family PhysiciansAfter completion of this article, the physician should be better able to choose appropriate therapies for hyperthyroidism in pregnant women, assess the risk of possible complications due to maternal hyperthyroidism, and evaluate strategies for patient follow-up. |
| Databáze: | OpenAIRE |
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