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Pregnancy Bliss | Reproductive Health Hub

Continues from previous page

Is there any treatment for an overactive thyroid (hyperthyroidism) condition in pregnancy?

Yes; there are two main types of medication that can be used in pregnancy. Both are considered safe.

Propylthiouracil (PTU) is preferred in North America and Carbimazole (Neo-Mercazole®) is used more in most of Europe. They are both very effective.

Does this mean these drugs do not cross the placenta to the baby?Carbimazole can be used in pregnancy

They both cross the placenta. This is why just the optimal dose needs to be used to control the disease. Excessive doses have the potential of suppressing the developing thyroid gland of the fetus causing goitre. Evidence shows that in optimal doses, these two drugs are quite safe for the baby.

I have heard of people with hyperthyroidism being treated with radioactive iodine. Can this be used during pregnancy?                           

No. This can permanently destroy the fetal thyroid gland.

Can surgery be an option for a woman with hyperthyroidism during pregnancy?

Surgery is certainly an option. However, this is only considered if medical treatment proves unsuccessful at controlling the hyperthyroidism. Surgery will normally take the form of partial resection of the gland. Surgery is usually only considered after 20 weeks of gestation.

Is the baby in the clear once the maternal condition is controlled?

In cases where the hyperthyroidism was due to Graves' disease, there is still a risk that the baby will be affected, regardless of the level of control in the mother. At least one in ten such babies are born with Graves' disease because of passage of the antibodies from mother to baby across the placenta.

The drugs suppress the production of the hormone but do not eliminate the rogue antibodies. The condition in the baby is transient.

Does pregnancy itself have any effect at all on the hyperthyroidism?

Yes. Graves' disease will tend to go into partial remission during pregnancy. However, treatment will still be required in almost all cases, even though for those already on treatment, the dose may be reduced. Delivery is usually followed by exacerbation of the condition.

Can a woman taking prapylthiouracil (PTU) breast­feed?

Yes. Even though a very small amount of the drug is found in breast-milk, it is not considered to be in sufficient quantities to cause unwanted effects.

Can a woman taking carbimazole breast-feed?

Yes. The advice is actually similar as for PTU above. The lowest effective dose should be used and the baby's growth progress monitored.

What is a "thyroid storm"?

This is a rare complication of hyperthyroidism. It may be triggered by infection, labour or surgery (such as caesarean section). It may also complicate surgery undertaken to treat the disease itself.

It is a result of a release of massive quantities of the thyroid hormone into the bloodstream. It is characterized by a very high temperature, high heart rate (and palpitations), dehydration and extreme agitation. page

Both Carbimazole and PTU can be used in pregnancy under a  physician’s observation to ensure maintaining safe drug levels for the baby

PTU can be used in pregnancy Hypothyroidism Medication Thyroid storm Graves' disease