Drug treatment for Graves’ disease during pregnancy-experience with 50 pregnancies

Summary

During the years 1985 to 1994 we followed 50 pregnancies of 46 women, age 22–42, with Graves’ disease, divided in three groups depending on thyroid status upon their first examination after pregnancy was established. A: (seven pregnancies) Graves’ and pregnancy were diagnosed concomitantly. B: (15 pregnancies) Graves was in remission and no medication was being used. C: (28 pregnancies) Graves was being treated with drugs. The patients were followed clinically and by T4 RIA, T3 RU and FTI measurements. The drugs used were either carbimazole or propylthiouracil. During delivery T₃, T₄ and TSH were measured in the umbilical cord of 34 out of the 50 neonates. During pregnancy treatment was discontinued in 317 pregnancies of group A, in 15/28 of C, while the 15 women of B remained in remission without treatment. All neonates were euthy-roid. During the next two years after delivery, 28/46 women relapsed. We conclude that (a) Graves’ remains in remission during the second and third trimesters, once successful remission has been achieved during the first; (b) neonatal morbidity is not increased whereas there is a high (60 per cent) rate of postpartum relapse.