Safest treatment for hyperthyroidism in pregnant women is
Ans. d (Propylthiouracil). (Ref. Harrison, Internal Medicine, 18th ed.,/Chapter 40., KD Tripath 5th/232)Propylthiouracil:# During pregnancy thyroidectomy and I131 are contraindicated. With anti-thyroid drugs risk of foetal hypothyroidism and goiter are there.# However, low doses of propylthiouracil are preferred as it has greater protein binding, allowing less transfer to foetus. For the same reason it is preferred in nursing mothers also.HYPERTHYROIDISM IN PREGNANCYHyperthyroidism in pregnancy should be aggressively evaluated and treated. It is most commonly caused by Graves disease, but autonomously functioning nodules, gestational trophoblastic disease, thyroiditis, and hyperemesis gravidarum should also be considered. Methimazole crosses the placenta to a greater degree than propylthiouracil and has been associated with fetal aplasia cutis. However, propylthiouracil can be associated with liver failure. Some experts recommend propylthiouracil in the first trimester and methimazole thereafter. Radioiodine should not be used during pregnancy, either for scanning or treatment, because of effects on the fetal thyroid. In emergent circumstances, additional treatment with beta blockers and a saturated solution of potassium iodide may be necessary. Hyperthyroidism is most difficult to control in the first trimester of pregnancy and easiest to control in the third trimester.
Radioactive iodine
Methimazole
Carbimazole
Propylthiouracil
Endocrinology