Management of hyperthyroidism during pregnancy in Asia

Fereidoun Azizi, Atieh Amouzegar, Ladan Mehran, Farzaneh Sarvghadi, Shahram Alamdari, Imam Subekti, Bijay Vaidya, Kris Poppe, Teofilo San Luis, Takashi Akamizu

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Maternal hyperthyroidism in pregnancy is associated with adverse impacts on both mother and fetus. Recently, the American Thyroid Association and the Endocrine Society have published guidelines for the management of thyroid diseases in pregnancy. We aimed to disclose the impact of these guidelines in current practices of Asian members of the Asia-Oceania Thyroid Association (AOTA) regarding the management of hyperthyroidism in pregnancy. Completed questionnaire survey, based on clinical case scenarios, was collected from 321 Asian physician members of AOTA from 21 Asian countries in 2013. For a woman with Graves’ disease planning pregnancy, 92% of clinicians favored antithyroid treatment, 52% with propylthiouracil (PTU) while 40% preferred methimazole (MMI). For a pregnant woman with newly diagnosed overt hyperthyroidism, nearly all responders initiated PTU treatment. To monitor dosage of antithyroid drugs, approximately 73% of responders used TSH and free T4 (FT4) levels without free T3 (FT3) (53%) or with FT3 (20%). Majority of responders targeted achieving low serum TSH with FT4 (or total T4) in the upper end of the normal range. For management of gestational thyrotoxicosis, 40% chose to follow up and 52% treated patients with PTU. Although timing of TSH receptor antibodies measurement in pregnant hyperthyroid patients was variable, 53% of responders would check it at least once during pregnancy. Nearly 80% of responders do not treat subclinical hyperthyroidism in pregnancy. Therefore, despite wide variations in the management of hyperthyroidism during pregnancy in Asia, majority of Asian physicians practice within the recommendations of major professional societies.

Original languageEnglish
Pages (from-to)751-758
Number of pages8
JournalEndocrine Journal
Volume61
Issue number8
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Hyperthyroidism
  • Management
  • Pregnancy

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