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Hyperthyroidism Associated With Pregnancy

From the Department of Internal Medicine (Nuclear Medicine) University of Michigan Medical Center. Ann Arbor. Michigan and the Northland Thyroid Laboratory. Southfield. Michigan.

Of 39 pregnant hyperthyroid patients, 3 were untreated and 1 had surgery alter antithyroid drug (ATD) toxicity. In the infants of 14 patients not closely followed, there were two neonatal goiters and three deaths (in each case one of a pair of twins, the other being normal). Twenty infants of closely followed patients were normal; 1 infant 1 ‘I goiter (the mother had received supplemental thyroid hormone throughout pregnancy). Supplemental thyroid hormone seems undesirable because it obscures laboratory indices of ATD overdosage, complicates recognition of remission in hyperthyroidism (5 patients in our series), and may necessitate higher ATI) dosage. With proper clinical and laboratory followup, excellent results can be achieved with ATD, without STH. Progressive ATD reduction in anticipation of the amelioration of hyperthyroidism characteristic of advanced pregnancy is emphasized.