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104. Patients receiving ATD for GD when becoming pregnant or found
to have GD during pregnancy should have TRAb levels measured at
initial pregnancy visit or at diagnosis using a sensitive assay and, if
elevated, again at 18–22 weeks of gestation. (S-L)
105. Patients with elevated TRAb levels at 18–22 weeks of gestation
should have TRAb remeasured in late pregnancy (weeks 30–34) to
guide decisions regarding neonatal monitoring. An exception to this
is a woman with an intact thyroid who is no longer in need of ATD
therapy. (S-L)
Postpartum Thyroiditis
106. In women developing thyrotoxicosis after delivery, selective
diagnostic studies should be performed to distinguish postpartum
destructive thyroiditis from postpartum GD. (S-L)
107. In women with symptomatic thyrotoxicosis from postpartum
destructive thyroiditis, the judicious use of β-adrenergic blocking
agents is recommended. (S-L)
108. In pregnant women diagnosed with hyperthyroidism due to
multinodular thyroid autonomy or a solitary toxic adenoma, special
care should be taken not to induce fetal hypothyroidism by ATD
therapy. (S-L)
