It is now considered that hyperthyroidism is not aggravated by pregnancy although physiological changes of pregnancy simulate features of mild thyrotoxicosis, and thus diagnosis can be difficult. In severe untreated cases, incidences of vomiting, abortion, premature labor and toxaemia rises; moreover there lies a rate possibility of congenital thyrotoxicosis. Diagnosis of thyrotoxicosis rests mainly on clinical features which are to be supplemented by raised B.M.R. and P.B.I. above those of pregnancy levels. Radioactive iodine test is not done during pregnancy because of its risk to irradiate foetal thyroid.
Treatment:
Medical: Mild cases can be managed by phenobarbitone 30mg. b.d. and more rest. Severe cases can be managed by controlled doses of antithyroid drugs - carbamizole 10mg. three time a day, later reduced to 5 mg. two times a day or potassium perchlorate 250 mg. t.i.d. Excess of antithyroid drugs can pass to the foetus causing goiter and even congenital hypothyroidism; mother may also become hypothyroid having abortion and premature labor. Thus these drugs must be well-congenital to get the woman euthyroid, and dosage should be as minimal as necessary. On antithyroid, risk of leucopenioa and very rarely agranulocytosis remains. Antithyroid drugs get excreted through breast milk and thus mother receiving these drugs should not feed her baby on breasts.
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