29
High FT4
and/or (F)T3
Check TRAb or TSI
a
Treat for Graves' disease
(Recommendations
Table 15 and 17)
• Follow-up TSH and FT4 every 2–4 weeks
• Target a FT4 at or slightly above the
upper third of the reference interval
• Always perform fetal ultrasound
monitoring starting at 18–20 weeks if
(1) ATDs are used, or (2) when the
TRAb/TSI is above 3× ULN
Negative
Positive
Overt
hyperthyroidism
b
Assess for a palpable thyroid nodule. If present, then follow biochemical progression and consider
ATDs depending on severity of hyperthyroidism. For example, repeat TRAb and/or TSI, (F)T3
measurement, thyroid ultrasound, and postpartum diagnostic imaging.
