How to treat patients with hyperthyroidism, how to treat a small impact on the fetus

Recently, some readers asked me: Can you get pregnant?Can hyperthyroidism take medicine during pregnancy?Today, let’s talk about this problem. These knowledge is only for everyone to understand, not as guidance of specific diseases, and do not take the seat. Specifically, you still have to go to the hospital for treatment.We discuss two parts:

Hyperthyroidism had been diagnosed before pregnancy

According to the guidelines for hyperthyroidism in the United States in 2016, if hyperthyroidism caused by Graves, after the treatment of anti -thyroid drugs is stable, and there is a planned pregnancy, the following suggestions are given:

Patients can consider radical treatment before pregnancy, which means that iodine 131 or surgery can be considered to achieve the purpose of cure.Oral drugs are not cure, because the recurrence rate of drug suspension is still very high.

You can try to translate to propyl oxyraine (PTU) treatment before pregnancy

Once diagnosed with pregnancy and transformed into propyl oxymidine (PTU) for treatment

Hyperthyroidism can consider stopping the drug and monitor the thyroid function.

However, the recommendation level of these suggestions is relatively low, and the relevant evidence level is not high, but it can be used as a reference.Doctors and patients are discussed together to determine based on the specific situation of each person.

After pregnancy, I found hyperthyroidism

If you find hyperthyroidism (especially Graves disease) after pregnancy, unless the light hyperthyroidism can be observed closely, at the same time, it is eliminated with pregnancy -related thyroid disease or pregnancy vomiting.Generally, treatment is needed.Because hyperthyroidism is not treated, hyperthyroidism can be aggravated. If it is severely caused by hyperthyroidism, it can also cause premature birth, abortion, and gestational hypertrophy of pregnant women. In particular, the hazard of hyperthyroidism is dangerous.

Hyperthyroidism after pregnancy is mainly drug treatment. Pregnancy is not a taboo for oral medication, but oral drugs have certain risks to the fetus. As patients, they need to understand.At present, hyperthyroidism is hyperthyroidism.

Both drugs can pass a small amount through the placenta. Because the PTU is high to the protein, the amount of the placenta is less, but it does not mean that it does not pass the placenta.

I mainly talk about the impact on the fetus. The side effects of hyperthyroidism drugs can be referred to the previous articles.

MMI (MMI) and propyl oxyraine (PTU) may cause fetal hypothyroidism, fetal goiter, and hypothyroidism.MMI (MMI) also has reports of fetal malformations, such as scalp defects, dysplasia of leather development.

How to use medicine with hyperthyroidism, how to use medicine

Patients with hyperthyroidism at present are drug treatment. The current guidelines are recommended for early pregnancy (first 3 months): choose propyl oxyraine (PTU) for treatment, and in the middle and late stages for treatment.Because tadoramidazole is more damage to the liver than propyl oxide.

Some readers asked: Why do not need metalramazole in the early days? This is because methyimazole is more likely to cause fetal malformation. Although it is rare, there is such a possibility.

I personally think that both drugs can be used through the placenta and may have teratogenic effects. Although we emphasize the teratogenic effect of metalazole (MMI), propyl oxyraine cannot fully check this possibility.If the amount of anti -thyroid drugs before pregnancy is small, for example, only the maintenance amount is used, it is also possible to use a drug throughout the pregnancy.

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