Therapy insight: management of Graves' disease during pregnancy.

Therapy insight: management of Graves' disease during pregnancy. Research Abstract Details 

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Therapy insight: management of Graves' disease during pregnancy. Abstract Text:

Grace W Chan,Susan J Mandel,

The diagnosis of Graves' disease in pregnancy can be complex because of normal gravid physiologic changes in thyroid hormone metabolism. Mothers with active Graves' disease should be treated with antithyroid drugs, which impact both maternal and fetal thyroid function. Optimally, the lowest possible dose should be used to maintain maternal free thyroxine levels at or just above the upper limit of the normal nonpregnant reference range. Fetal thyroid function depends on the balance between the transplacental passage of thyroid-stimulating maternal antibodies and thyroid-inhibiting antithyroid drugs. Elevated levels of serum maternal anti-TSH-receptor antibodies early in the third trimester are a risk factor for fetal hyperthyroidism and should prompt evaluation of the fetal thyroid by ultrasound, even in women with previously ablated Graves' disease. Maternal antithyroid medication can be modulated to treat fetal hyperthyroidism. Serum TSH and either total or free thyroxine levels should be measured in fetal cord blood at delivery in women with active Graves' disease, and those with a history of (131)I-mediated thyroid ablation or thyroidectomy who have anti-TSH-receptor antibodies. Neonatal thyrotoxicosis can occur in the first few days of life after clearance of maternal antithyroid drug, and can last for several months, until maternal antibodies are also cleared.

Therapy insight: management of Graves' disease during pregnancy. Publishing Authors By Initials

GW Chan,SJ Mandel,

For similar female urogenital diseases and pregnancy complications: pregnancy complications research abstracts see: female urogenital diseases and pregnancy complications: pregnancy complications research

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Therapy insight: management of Graves' disease during pregnancy. Journal Published:

PUBLICATION TYPE: Review

Journal: Nature clinical practice. Endocrinology & metaboli

VOLUME: 3

Page Numbers: 470-8

Journal Abbreviation:

ISSN: 1745-8374

DAY: 3

MONTH: Jun

YEAR: 2007

Therapy insight: management of Graves' disease during pregnancy. Information

Number of References: 72

LANGUAGE: eng

NlmUniqueID: 101261798

Therapy insight: management of Graves' disease during pregnancy. Keywords Mesh Terms:

KEYWORDS: Pregnancy Complications

MESH TERMS: therapy

Chemical & Substance for Abstract: Therapy insight: management of Graves' disease during pregnancy. Information

Substance Name: Antithyroid Agents

Registry Number: 0

Grant and Affiliation Information for Therapy insight: management of Graves' disease during pregnancy.

AFFILIATION: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Country: England

AGENCY: United States NIDDK

GRANT: 2-T32-DK007314-26

ACRONYM: DK

MEDLINETA: Nat Clin Pract Endocrinol Meta

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