Skip to main content
SpringerLink
Log in

Drug Therapy for Hyperthyroidism in Pregnancy

Safety Issues for Mother and Fetus

  • Review Article
  • Published:
Drug Safety Aims and scope Submit manuscript

Abstract

Hyperthyroidism (thyrotoxicosis) in pregnancy and the child bearing years is usually attributable to Graves’ disease. This is an autoimmune condition in which thyroid-stimulating immunoglobulins (TSI) cause hyperthyroidism. As a rule, pregnancy complicates the management of hyperthyroidism, rather than vice versa. However, patients who remain thyrotoxic during pregnancy are at increased risk of maternal and fetal complications, particularly miscarriage and stillbirth. Therefore, bodyweight loss, eye signs and a bruit over the thyroid gland in a pregnant woman warrant thyroid investigation. Investigations should include measurement of serum free thyroid hormone levels [free thyroxine (T4) and free triiodothyronine (T3)] rather than total T4 and T3 levels, because total T4 and T3 levels may be raised in euthyroid pregnancies due to the presence of increased levels of thyroxine binding globulin (TBG).

By 20 weeks’ gestational age, the fetal thyroid is fully responsive to TSI and to antithyroid drugs. Maternal T4 and T3 and thyrotropin pass across the placenta in small and decreasing amounts as gestation progresses, but thyrotropin releasing hormone, TSI, antithyroid drugs, iodides and β-blockers are readily transferred to the fetus from the mother.

Hyperthyroidism is usually treated throughout pregnancy with an antithyroid drug, preferably propylthiouracil. The smallest dose which controls the disease is given with careful monitoring of free T4 and T3 levels to minimise the risk of fetal hypothyroidism and goitre. Bilateral subtotal thyroidectomy may be an option for a small number of patients with hyperthyroidism in pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I
Table II

Similar content being viewed by others

References

  1. Davis LE, Lucas MJ, Hankins GD, et al Thyrotoxicosis complicating pregnancy. Am J Obstet Gynecol 1989; 160: 63–70

    PubMed  CAS  Google Scholar 

  2. Lim BH, Raman S, Sivanesaranam V, et al. Thyrotoxicosis in pregnancy: a six year review. Singapore Med J 1989; 30: 539–41

    PubMed  CAS  Google Scholar 

  3. Burrow GN. Thyroid function and hyperfunction during gestation Endocrine Rev 1993; 14: 194–202

    CAS  Google Scholar 

  4. Hamburger JI. Diagnosis and management of Graves’ disease in pregnancy. Thyroid 1992; 2: 219–24

    PubMed  CAS  Google Scholar 

  5. Vanderpump MPJ, Tunbridge WMG, French JM, et al. The incidence of thyroid disorders in the community: a twenty year follow up of the Whickam study. Clin Endocrinol 1995; 43: 55–68

    CAS  Google Scholar 

  6. Becks GP, Burrow GN. Thyroid disease and pregnancy. Med Clin North Am 1991; 75: 121–50

    PubMed  CAS  Google Scholar 

  7. Reed Larsen P, Ingbar SH. The thyroid gland. In: Wilson JD, Foster DW, editors. Williams’ textbook of endocrinology. 8th ed. Philadelphia: WB Saunders, 1992; 357–487

    Google Scholar 

  8. ACOG Technical Bulletin No 181. Thyroid disease in pregnancy. Int J Gynecol Obstet 1993; 43: 82–8

    Google Scholar 

  9. Farwell AP, Braverman LE. Thyroid and antithyroid drugs. In: Hardman JG, Limbird LE, Molinoff PB, et al., editors. Goodman & Gilman. The pharmacological basis of therapeutics. 9th ed. McGraw Hill, 1995: 1383–409

    Google Scholar 

  10. Glinoer D, De Nayer P, Bordoux P, et al Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990; 71: 276–97

    PubMed  CAS  Google Scholar 

  11. Harada K, Hirshman M, Reed AW, et al. Comparison of thyroid stimulators and thyroid hormone concentrations in sera of pregnant women. J Clin Endocrinol Metab 1979; 48: 793–7

    PubMed  CAS  Google Scholar 

  12. Ain KB, Refetoff S. Relationship of oligosaccharide modification to the cause of serum thyroxine-binding globulin excess. J Clin Med Endocrinol Metab 1988; 66: 1037–43

    CAS  Google Scholar 

  13. Surks MI, Chopra IJ, Mariash CN, et al. American thyroid association guidelines for use of laboratory tests in thyroid disorders. JAMA 1990; 263: 1529–32

    PubMed  CAS  Google Scholar 

  14. Momotani N, Ito K, Hamada N, et al. Maternal hyperthyroidism and congenital malformation in the offspring. Clin Endocrinol 1984; 20: 695–700

    CAS  Google Scholar 

  15. Ross McDougall. I Hyperthyroidism & maternal - fetal thyroid hormone metabolism. In: Brody SA, Ueland K, editors. Endocrine disorders in pregnancy. Connecticut: Appleton & Lange, 1989; 151–63

    Google Scholar 

  16. Menon V, McDougall WW, Leatherdale BA. Thyrotoxic crisis following eclampsia and induction of labour. Postgrad Med J 1982; 58: 286–7

    PubMed  CAS  Google Scholar 

  17. Tietgens ST, Leinung MC. Thyroid storm. Med Clin North Am 1995; 79: 169–84

    PubMed  CAS  Google Scholar 

  18. Bruner JP, Landon MB, Gabbe SG. Diabetes mellitus and Graves’ disease complicated by maternal allergies to antithyroid drugs. Obstet Gynecol 1988; 72: 443–5

    PubMed  CAS  Google Scholar 

  19. Lazarus JH, Othman S. Thyroid disease in relation to pregnancy. Clin Endocrinol 1991; 34: 91–3

    CAS  Google Scholar 

  20. Montoro M, Mestman JH. Graves’ disease and pregnancy. N Engl J Med 1981; 305: 48

    Google Scholar 

  21. Thorpe-Beeston JF, Nicolaides KH, Felton CV, et al Maturation of the secretion of thyroid hormone and thyroid stimulating hormone in the fetus. N Engl J Med 1991; 324: 532–6

    PubMed  CAS  Google Scholar 

  22. Fisher DA. Thyroid function in very low birth weight infants Clin Endocrinol 1997; 47: 419–21

    CAS  Google Scholar 

  23. Roti E, Gnudi A, Braverman LE. The placental transport synthesis and metabolism of hormones and drugs which affect thyroid function. Endocrinol Rev 1983; 4: 131–49

    CAS  Google Scholar 

  24. Vulsma T, Gons MH, De Vijlder JM. Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect of thyroid agenesis. N Engl J Med 1989; 321: 13–6

    PubMed  CAS  Google Scholar 

  25. Munro DS, Dirmikis SM, Humphries H, et al. The role of thyroid stimulating immunoglobulins of Graves’ disease in neonatal thyrotoxicosis. Br J Obstet Gynecol 1978; 85: 837–43

    CAS  Google Scholar 

  26. Khoury MJ, Becerra JE, D’Almida PJ. Maternal thyroid disease and risk of birth defects in offspring: a population based control study. Paediatr Perinat Epidemiol 1989; 3: 402–20

    PubMed  CAS  Google Scholar 

  27. Wing DRA, Millar LK, Koonings PP, et al. A comparison of propylthiouracil versus methimazole in the treatment of hyperthyroidism in pregnancy. Am J Obstet Gynecol 1994; 170: 90–5

    PubMed  CAS  Google Scholar 

  28. Cooper DS. Antithyroid drugs. N Engl J Med 1984; 311: 1353–62

    PubMed  CAS  Google Scholar 

  29. Marchant B, Brownlie BEW, Hart DM, et al. The placental transfer of propylthiouracil, methimazole and carbimazole. J Clin Endocrinol Metab 1977; 45; 1187–92

    PubMed  CAS  Google Scholar 

  30. Senior B, Chernoff HL. Iodide goiter in the newborn. Pediatrics 1971; 47: 510–5

    PubMed  CAS  Google Scholar 

  31. Salv M, How J. Pregnancy and autoimmune thyroid disease. Endocrinol Metab Clin North Am 1987; 16: 431–44

    Google Scholar 

  32. Amino N, Kuro R, Tanizawa O, et al. Changes of serum antithyroid antibodies during and after pregnancy in autoimmune thyroid disease. Clin Exp Immunol 1978; 31: 30–7

    PubMed  CAS  Google Scholar 

  33. Wartofsky L, Glinoer D, Spolomon B, et al. Differences and similarities in the diagnosis and treatment of Graves’ disease in Europe, Japan and the United States. Thyroid 1991; 1: 129–35

    PubMed  CAS  Google Scholar 

  34. Franklyn JA, Daykin J, Drole Z, et al. Long term follow up of treatment of thyrotoxicosis by three different methods. Clin Endocrinol (Oxf) 1991; 34: 71–6

    CAS  Google Scholar 

  35. Sheldon J, Reid DJ. Thyrotoxicosis: changing trends in treatment. Ann R Coll Surg Engl 1986; 68: 283–5

    PubMed  CAS  Google Scholar 

  36. Singer PA, Cooper DS, Levy EG, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA 1995; 273: 808–12

    PubMed  CAS  Google Scholar 

  37. Lazarus JH. Guidelines for the use of radioactive iodine in the management of hyperthyroidism. J R Coll Phys Lond 1995; 29: 464–9

    CAS  Google Scholar 

  38. O’Doherty MJ, McElhatton PR, Thomas SHI. Treating thyrotoxicosis in pregnant or potentially pregnant women. BMJ 1999; 1: 5

    Google Scholar 

  39. Patwardhan NA, Moroni M, Rao S, et al. Surgery still has a role in Graves’ hyperthyroidism. Surgery 1993; 114: 1108–13

    PubMed  CAS  Google Scholar 

  40. Belchetz PE. Thyroid disease in pregnancy. BMJ 1987; 294: 264–5

    PubMed  CAS  Google Scholar 

  41. Stice RC, Grant CS, Ghari H, et al Themanagement of Graves’ disease during pregnancy. Surg Gynecol Obstet 1984; 158; 157–60

    PubMed  CAS  Google Scholar 

  42. Ghaneim A, Atkins P. Management of thyrotoxicosis in pregnancy. Int J Clin Pract 1998; 52: 36–8

    PubMed  CAS  Google Scholar 

  43. Hawe P, Francis HH. Pregnancy and thyrotoxicosis. BMJ 1962; 2: 817–22

    PubMed  CAS  Google Scholar 

  44. Hawe P. The management of thyrotoxicosis during pregnancy. Br J Surg 1965; 52: 731–4

    PubMed  CAS  Google Scholar 

  45. Pekonen F, Lamberg BA. Thyrotoxicosis during pregnancy Ann Chir Gynaecol 1978; 67: 165–73

    PubMed  CAS  Google Scholar 

  46. Astwood EB. Treatment of hyperthyroidism with thiourea and thiouracil. JAMA 1943; 122: 78–81

    CAS  Google Scholar 

  47. Franklyn JA. The management of hyperthyroidism. N Engl J Med 1994; 330: 1731–8

    PubMed  CAS  Google Scholar 

  48. Carbimazole. Therapeutic drugs. Vol 1. Dollery C, editor. Edinburgh: Churchill Livingstone, 1991; C66–69

  49. Propylthiouracil therapeutic drugs. Vol 2. Dollery C, editor. Edinburgh: Churchill Livingstone, 1991: P282–287

  50. Totterman TH, Karlsson FA, Bengtsson M. Induction of circulating activated suppressor-like T cells by methimazole therapy for Graves’ disease. N Engl J Med 1987; 316: 15–22

    PubMed  CAS  Google Scholar 

  51. Cooper DS. Which anti-thyroid drug? Am J Med 1986; 80: 1165–8

    PubMed  CAS  Google Scholar 

  52. Cooper DS, Goldminz D, Levin AA, et al. Agranulocytosis associated with antithyroid drugs: effects of patient age and drug dose. Ann Intern Med 1983; 98: 26–9

    PubMed  CAS  Google Scholar 

  53. Vanderpump MPJ, Ahlquist JAO, Franklyn JA, et al. Consensus statement for good practice and audit measures in the management of hypothyroidism and hyperthyroidism. BMJ 1996; 313: 539–44

    PubMed  CAS  Google Scholar 

  54. Meyer-GeBner M, Benker G, Lederbogen S. Antithyroid drug induced agranulocytosis. Clinical experience with ten patients treated at one institution and review of the literature. J Endocrinol Invest 1994; 17: 29–36

    Google Scholar 

  55. Mujitaba Q, Burrow GN. Treatment of hyperthyroidismin pregnancy with propylthiouracil and methimazole. Obstet Gynecol 1975; 46: 282–6

    Google Scholar 

  56. Milham Jr S, Elledge W. Maternal methimazole and congenital defects in children. Teratology 1972; 5: 125–6

    Google Scholar 

  57. Van Dijke CP, Heydendael RJ, De Kleine MJ. Methimazole, carbimazole, and congenital skin defects. Ann Intern Med 1987; 106: 60–1

    PubMed  Google Scholar 

  58. Cheron RG, Kaplan MM, Larsen PR, et al. Neonatal thyroid function after propylthiouracil therapy for maternal Grave’ disease. N Engl J Med 1981; 304: 525–8

    PubMed  CAS  Google Scholar 

  59. Momotani N, Noh J, Oyanagi H, et al. Antithyroid drug therapy for Grave’s disease during pregnancy. N Engl J Med 1986; 315: 24–8

    PubMed  CAS  Google Scholar 

  60. Burrow GN, Bartsosocas C, Klatskin EH, et al. Children exposed in utero to propylthiouracil: subsequent intellectual and physical development. Am J Dis Child 1968: 116; 161–5

    PubMed  CAS  Google Scholar 

  61. McCarroll AM, Hutchinson M, McAuley R, et al. Long term assessment of children exposed in utero to carbimazole. Arch Dis Child 1976; 51: 532–6

    PubMed  CAS  Google Scholar 

  62. Messer PM, Hauffa BP, Olbricht T, et al. Antithyroid drug treatment of Graves’ disease in pregnancy: long term effects on somatic growth, intellectual development and thyroid function in offspring. Acta Endocrinol (Copenh) 1990; 123: 311–6

    CAS  Google Scholar 

  63. Mandel SJ, Brent Ga, Larsen PR. Review of antithyroid drug use in pregnancy and report of a case of aplasia cutis. Thyroid 1994; 4: 129–33

    PubMed  CAS  Google Scholar 

  64. Kampmann JP, Johansen K, Hansen JM, et al. Propylthiouracil in human milk: revision of dogma. Lancet 1980; I: 736–7

    Google Scholar 

  65. Mortimer RH, Cannell GR, Addison RS, et al. Methimazole and propylthiouracil equally cross the perfused human term placenta lobule. J Clin Endocrinol Metab 1997; 82; 3099–102

    PubMed  CAS  Google Scholar 

  66. Benker G, Vitti P, Kahal G, et al. Response to methimazole in Graves’ disease. Clin Endocrinol 1995; 43: 259–63

    Google Scholar 

  67. Okamura K, Ikenoue H, Shiroozu A, et al. Reevaluation of the effects of methylmercaptoimidazole and propylthiouracil in patients with Graves’ hyperthyroidism. J Clin Endocrinol Metab 1987; 65: 719–23

    PubMed  CAS  Google Scholar 

  68. Romaldini JH, Bromberg N, Werner RS, et al. Comparison of effects of high and low dose regimens of antithyroid drugs in the management of Graves; hyperthyroidism. J Clin Endocrinol Metab 1983; 57: 563–70

    PubMed  CAS  Google Scholar 

  69. Jorde R, Yire-Arne K, Stormer J, et al. Short term treatment of Graves’ disease with methimazole in high versus low doses. J Intern Med 1995; 238: 161–5

    PubMed  CAS  Google Scholar 

  70. Meng W, Meng S, Manchen E, et al. Effect of therapy duration and low and highly dosed thiamazole treatment on Basedow Graves’ disease. Exp Clin Endocrinol 1991; 97: 257–60

    PubMed  CAS  Google Scholar 

  71. Reinwen D, Benker JH, Lazarus JH, et al. A prospective randomized trial of antithyroid drug in Graves’ disease therapy. European Multicentric Study Group on Antithyroid drug treatment. J Clin Endocrinol Metab 1993; 76: 1516–21

    Google Scholar 

  72. Wilson R, Buchanan L, Fraser WD, et al. Do higher doses of carbimazole improve remission in Graves’ disease? Q J Med 1996; 89: 381–5

    Google Scholar 

  73. Hashizume K, Ichikawa K, Sakurai A. Administration of thyroxine in treated Graves’ disease: effects on the level of antibodies to thyroid stimulating receptors and on the risk of recurrence of hyperthyroidism. N Engl J Med 1991; 324: 947–53

    PubMed  CAS  Google Scholar 

  74. Edmonds CJ, Telez M. Treatment of Graves’ disease by carbimazole high dose with thyroxine compared to titration dose. Eur J Endocrinol 1994; 131: 120–4

    PubMed  CAS  Google Scholar 

  75. McIver B, Rae P, Beckett G, et al. Lack of effect of thyroxine in patients with Graves’ hyperthyroidism who are treated with an antithyroid drug. N Engl J Med 1996; 334: 220–4

    PubMed  CAS  Google Scholar 

  76. Allanic R, Fauchet J, Orgiazzi AM, et al. Antithyroid drugs and Graves’ disease: a prospective randomized evaluation of the efficacy of treatment duration. J Clin Endocrinol Metab 1990; 70: 675–9

    Google Scholar 

  77. Weetman AP, Pickerell AP, Watson P. Treatment of Graves’ disease with the block-replace regimen of antithyroid drugs: the effect of treatment duration and immunogenetic susceptibility on relapse. Q J Med 1994; 87: 337–41

    PubMed  CAS  Google Scholar 

  78. Hashizume K, Ichikawa K, Nishi Y, et al. Effect of administration of thyroxine on the risk of post partum recurrence of hyperthyroid Graves’ disease. J Clin Endocrinol Metab 1992; 75: 6–10

    PubMed  CAS  Google Scholar 

  79. Ramsay I, Kaui S, Krassas G. Thyrotoxicosis in pregnancy: results of treatment by antithyroid drugs combined with T4. Clin Endocrinol 1983 18: 73–85

    CAS  Google Scholar 

  80. Kriplani A, Buckshee K, Bhargava VL, et al. Maternal and perinatal outcome in thyrotoxicosis complicating pregnancy. Eur J Obstet Gynecol Reprod Biol 1994; 54: 159–63

    PubMed  CAS  Google Scholar 

  81. Girling JA. Thyroid disease and pregnancy. Br J Hosp Med 1996; 56: 316–20

    PubMed  CAS  Google Scholar 

  82. Matsuura N, Fujieda K, Yasuhiro I, et al. thyrotropin receptor antibodies in mothers with Graves’ disease and outcome in their offspring. Lancet 1988; I: 14–8

    Google Scholar 

  83. Ogilvy-Smith AL. Endocrinology of the neonate. Br J Hosp Med 1995; 54: 207–11

    Google Scholar 

  84. Rubin PC. Beta Blockers in pregnancy. N Engl J Med 1981; 305: 1323–6

    PubMed  CAS  Google Scholar 

  85. Bullock JL, Harris RE, Young R. Treatment of thyrotoxicosis during pregnancy with propranolol. Am J Obstet Gynecol 1973; 121: 242–5

    Google Scholar 

  86. Gladstone GR, Hordof A, Gersony WM. Propranolol administration during pregnancy: effects on the fetus. J Pediatr 1975; 86: 962–4

    PubMed  CAS  Google Scholar 

  87. Ueland K, McAnulty JH, Ueland FR, et al. Special consideration in the use of cardiovascular drugs. Clin Obstet Gynecol 1981; 24: 809–23

    PubMed  CAS  Google Scholar 

  88. Propranolol therapeutic drugs. Vol 1. Dollery C, editor. Edinburgh,: Churchill Livingstone, 1991; 272–8

  89. Campbell JW. A possible teratogenic effect of propranolol [letter]. N Engl J Med 1985; 313: 518

    PubMed  CAS  Google Scholar 

  90. Kyle PM, Redman CW. Comparative risk-benefit assessment of drugs used in the management of hypertension in pregnancy. Drug Saf 1992; 7: 223–34

    PubMed  CAS  Google Scholar 

  91. Carswell F, Kerr MM, Hutchison JH. Congenital goiter and hypothyroidism produced by maternal ingestion of iodides. Lancet 1970; I: 1241–3

    Google Scholar 

  92. Momotani N, Hisaoka T, Noh J, et al. Effects of iodine on thyroid status of fetus versus mother in treatment of Grave’s disease complicated by pregnancy. J Clin Endocrinol Metab 1992; 75: 738–44

    PubMed  CAS  Google Scholar 

  93. Iodine therapeutic drugs. Vol 1. Dollery C, editor. Edinburgh: Churchill Livingstone, 1991: I146–8

  94. Kamm ML, Weaver JC, Page EP, et al. Acute thyroid storm precipitated by labour. Obstet Gynecol 1963; 21; 460–3

    PubMed  CAS  Google Scholar 

  95. Burch HB, Wartofsky L. Life threatening thyrotoxicosis: thyroid storm. Endocrinol Metab Clin North Am 1993; 22: 263–77

    PubMed  CAS  Google Scholar 

  96. Cooper D. Treatment of thyrotoxicosis. In: Braverman LE, Utiger RD, editors. Werner and Ingbar’s The thyroid. 6th ed. Philadelphia (PA): Lippincott, 1991: 887–916

    Google Scholar 

  97. Wartofsky L. Thyroid storm. In: Braverman LE, Utiger RD, editors.Werner and Ingbar’s The thyroid. 6th ed. Philadelphia (PA): Lippincott, 1991: 871–9

    Google Scholar 

  98. Reid DJ, Hyperthyroidism and hypothyroidism complicating the treatment of thyrotoxicosis. Br J Surg 1987; 74: 1060–2

    PubMed  CAS  Google Scholar 

  99. Davenport M, Talbot JN, Thyroidectomy for Graves’ disease: is hypothyroidism inevitable? Ann R Coll Surg Engl 1989; 71: 87–91

    PubMed  CAS  Google Scholar 

  100. Younes N, Robinson B, Delbridge L. The aetiology, investigation and management of surgical disorders of the thyroid gland. Aust NZ J Surg 1996; 66: 481–90

    CAS  Google Scholar 

  101. Ross McDougall I Graves’ disease: current concepts. Med Clin North Am 1991; 75: 79–95

    Google Scholar 

  102. Miccoli P, Vitti P, Rago T, et al. Surgical treatment of Graves’ disease: subtotal or total thyroidectomy? Surgery 1996; 120: 1020–5

    PubMed  CAS  Google Scholar 

  103. Swaminathan R, Chin RK, Lao TTH, et al. Thyroid function in hyperemesis gravidarum. Acta Endocrinol 1989; 120: 155–60

    PubMed  CAS  Google Scholar 

  104. Goodwin TM, Montoro M, Mestman J. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992; 167: 648–52

    PubMed  CAS  Google Scholar 

  105. Lao T, Chin RKH, Chung AMZ. The outcome of hyperemetic pregnancies complicated by transient hyperthyroidism. Aust NZ J Obstet Gynecol 1987; 27: 99–101

    CAS  Google Scholar 

  106. Goodwin TM, Montoro M, Mestman JH, et al. The role of chorionic gonadotrophin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab 1992 75 1333–7

    PubMed  CAS  Google Scholar 

  107. Kennedy RL, Darne J, Cohen M, et al. Human chorionic gonadotropin (hCG) may not be responsible for the thyroid stimulating activity in normal pregnancy serum. J Clin Endocrinol Metab 1991; 72: 258–63

    Google Scholar 

  108. Tsurata E, Tada H, Tamaki H, et al. Pathogenic role of asialo human chorionic gonadotropin in gestational thyrotoxicosis. J Clin Endocrinol Metab 1995; 80: 350–5

    Google Scholar 

  109. Rodien P, Bremont C, Raffin Sanson ML, et al. Familial gestational hyperthyroidism caused by a mutant thyrotropin receptor hypersensitive to human chorionic gonadotropin. N Engl J Med 1998; 339: 1823–6

    PubMed  CAS  Google Scholar 

  110. Evans AJ, Li TC, Selby C, et al. Morning sickness and thyroid function. Br J Obstet Gynaecol 1986; 93: 520–2

    PubMed  CAS  Google Scholar 

  111. Rajatanavin R, Chailurkit LO, Srisupandit S, et al. Trophoblastic hyperthyroidism. Clinical and biochemical features of five cases. Am J Med 1988; 85: 237–41

    PubMed  CAS  Google Scholar 

  112. Amino N, Mori H, Iwatani Y, et al. High prevalence of transient post-partum thyrotoxicosis and hypothyroidism. N Engl J Med 1982; 306: 849–52

    PubMed  CAS  Google Scholar 

  113. Nikolai TF, Turney SL, Roberts RC. Post partum lymphocytic thyroiditis: prevalence: clinical course and long term follow up. Arch Intern Med 1987; 147: 221–4

    PubMed  CAS  Google Scholar 

  114. Walfish PCG, Meyerson J, Provias JP, et al. Prevalence and characteristics of post-partum thyroid dysfunction: results of a survey from Toronto, Canada. J Endocrinol Invest 1992; 15: 265–72

    PubMed  CAS  Google Scholar 

  115. Roti E, Emerson CH. Postpartum thyroiditis. J Clin Endocrinol Metab 1992; 74: 3–5

    PubMed  CAS  Google Scholar 

  116. Othman S, Philips DIW, Parkes AB, et al. A long term follow up of postpartum thyroiditis. Clin Endocrinol 1990; 32: 559–64

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Royal Liverpool University Hospital and Aintree Hospitals, Liverpool, England

    Paul Atkins

  2. Medical Disorders of Pregnancy Clinic, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, England

    Stanley B. Cohen

  3. Royal Liverpool University Hospital and Liverpool Women’s Hospital, Liverpool, England

    Brenda Joyce Phillips

Authors
  1. Paul Atkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stanley B. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brenda Joyce Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atkins, P., Cohen, S.B. & Phillips, B.J. Drug Therapy for Hyperthyroidism in Pregnancy. Drug-Safety 23, 229–244 (2000). https://doi.org/10.2165/00002018-200023030-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-200023030-00005

Keywords

Search

Navigation