Table 4

Management of Graves' hyperthyroidism in pregnancy

 Confirm diagnosis
Start propylthiouracil
Render patient euthyroid—continue with low dose antithyroid drugs up to and during labour
Monitor thyroid function regularly throughout gestation (4–6 weekly)
 Adjust antithyroid drugs if necessary
Check TsAb at 36 weeks' gestation
Discuss treatment with patient
 Effect on patient
 Effect on fetus
 Breast feeding
Inform obstetrician and paediatrician
Review postpartum—check for exacerbation