Factitious Hyperthyroidism in Pregnancy: First-Line Management in the First Trimester and Pre-Conception
Factitious hyperthyroidism occurring during pregnancy — with particular attention to the first trimester — and in women planning pregnancy calls for an antithyroid strategy that weighs both maternal disease control and fetal safety.
Clinical Scenario
This protocol is specifically indicated for pregnancy, with a focus on the first trimester, and for women who are planning to become pregnant. Antithyroid therapy selection in this population requires a different approach compared with non-pregnant adults.
Treatment Approach
Propylthiouracil is the recommended first-line antithyroid agent in this setting, titrated according to disease severity — the complete dosing strategy, titration steps, and monitoring schedule are detailed in the full structured protocol.
Treatment Target
Therapy aims to maintain free T4 / T4 concentrations in the upper half of the reference range, using the lowest effective dose.
References
DOI: 10.1089/thy.2016.0229
- Propylthiouracil is recommended as first line agent in women planning pregnancy and during the first trimester of pregnancy.
- The lowest effective dose should be used for thyrotoxicosis during pregnancy, targeting T4 concentrations in the upper half of the reference range.