25
Recommendations Table 13. Evaluation of Hyperthyroidism
in Pregnancy
Strength
*
Level
#
yroid function testing should not be pursued in pregnant
women with hyperemesis gravidarum if there are no other
clinical signs of hyperthyroidism
a
.
Good Practice Statement
yroid ultrasonography is not suggested as a method to
distinguish GTT from Graves' disease in pregnant women.
Conditional Low
Isotope scanning is contraindicated in pregnancy and should
not be used in the diagnostic evaluation of hyperthyroidism.
Good Practice Statement
a
Predominantly palpitations that persist aer rehydration and antiemetics. If palpitations are caused
by GTT, these can be treated symptomatically with propranolol.
* Strength of Recommendation;
#
Level of Evidence; Good Practice Statement.
Table 2. Distinguishing Between Gestational Transient
Thyrotoxicosis (GTT) and Graves' Disease
Feature GTT Graves' Disease
Symptoms of thyrotoxicosis
before pregnancy
None Oen
Symptoms of hyperemesis
gravidarum (nausea/vomiting )
Oen Usually not present
Personal or family history of
thyroid disease
Usually absent Oen present
Presence of goiter None/low May be present as
diffuse goiter
Signs of thyroid eye disease None May be present
Serum FT3 concentration
(Box 6)
Usually normal or mildly
raised
Raised
Serum TRAb and/or TSI
concentration
Normal Raised
Serum TT3 (ng/dL)/TT4
(mcg/dL) ratio
Typically <20 Typically >20
Serum TSH concentration Usually normalizes by the
third trimester of pregnancy
Oen suppressed
throughout pregnancy
Hyperthyroidism
