Pregnancy and Graves’ disease

About pregnancy and Graves’ disease
If hyperthyroidism continues for a long time, physiology may be reduced or stopped. However, because of Graves’ disease, it is not hard to get pregnant.
However, if you are pregnant with excess thyroid hormone, the risk of miscarriage or preterm birth increases. For safe pregnancy / childbirth, it is important to make thyroid hormone concentration normal in advance.
Treatment is centered on the administration of antithyroid drugs (thiurazil or propargyl) or potassium iodide. Some people feel uneasy about drinking medication during pregnancy. However, if Graves’ disease is pregnant, it is most important to keep thyroid hormone normal during pregnancy. About the antithyroid drug mercazole, there is a report that part of the baby’s scalp is missing although it is very rare only when it is internalized at the beginning of pregnancy. For thiurazir (propargyl) and potassium iodide, such an effect is not told at present.

Actually, many patients at our hospital are giving birth to a healthy baby. Please do not miss a marriage or pregnancy from the misunderstanding of Graves’ disease.

Antibodies specific to Graves’ disease, thyroid stimulating antibodies (TRAb and TSAb) are often lowered during pregnancy, but if these are also very high in the late pregnancy, this antibody will pass through the placenta to the fetus The thyroid gland may also be irritating. Then baby’s hyperthyroidism rarely occurs before and after birth. As this antibody disappears from the baby’s body in about 1 month after birth, baby’s hyperthyroidism is temporary and lightened, but in such a case treatment or follow-up in the neonatal department for a while after birth It is necessary.

Another concern is deterioration of Graves’ disease after childbirth. Graves’ disease improves naturally during pregnancy, but it may get worse after birth. This is a phenomenon that can be said as a reactionary reaction that got lighter during pregnancy. Even people who got worse after childbirth will not feel worried because you will regulate your medications. Breast-feeding is also possible if you ingest thiurazir (propargyl) or a small amount of mercazole.

■ Temporary hyperthyroidism caused by pregnancy
Thyroid hyperthyroidism in early pregnancy is not Graves’ disease. This is due to gonadotropic hormone (chorionic gonadotropin) made in the placenta. As the concentration of this hormone decreases in the middle of pregnancy, it will cure naturally accordingly. This happens at a rate of about 1 in 300 pregnant women.