Case Study: Hyperthyroidism in
Pregnancy
Pg 17-23
Introduction
Hyperthyroidism is characterized by an overactive thyroid gland with elevated thyroid
hormones, including free thyroxine (free T4) and free triiodothyronine (free T3).
Thyrotoxicosis refers to the presence of symptoms along with elevated thyroid hormones.
Thyroid disorders can have significant implications for pregnancy outcomes. Graves' disease
is a common cause of thyrotoxicosis in pregnancy, while transient gestational
hyperthyroidism is a temporary condition. Accurate diagnosis is crucial for appropriate
management.
Case : Hyperthyroidism in Pregnancy
Abstract
Graves' disease frequently occurs in women of reproductive age and is a prevalent cause of
thyrotoxicosis in pregnancy, affecting about 0.15% of cases. Additionally, transient
gestational hyperthyroidism, observed in 2–3% of European pregnancies, can impact
pregnancy outcomes. Proper diagnosis is crucial for guiding management. This case study
discusses the presentation, diagnosis, and management of three common causes of
thyrotoxicosis during pregnancy and the postpartum period.
Keywords
Pregnancy • Thyrotoxicosis • Hyperthyroidism • Thyroiditis • Maternal • Gestational •
Graves' disease
Case 1: Overt Thyrotoxicosis – Pre-pregnancy
A 34-year-old woman with a history of primary infertility and recent miscarriage is referred
due to abnormal thyroid function tests (TFTs). She complains of palpitations and weight loss
after her miscarriage. Questions regarding the onset and duration of her symptoms, along
with additional signs of thyrotoxicosis, such as increased appetite, heat intolerance, tremor,
anxiety, and poor concentration, help evaluate her condition.
Examination reveals signs of thyrotoxicosis, including tachycardia, warm extremities, and
tremor. A thorough assessment helps identify her condition as Graves' thyrotoxicosis,
explaining her infertility. TFTs and thyroid antibodies confirm the diagnosis. Proper
management involves controlling thyroid function with propylthiouracil (PTU) and closely
monitoring her levels before considering pregnancy again.
Case 2: First-Trimester Hyperthyroidism
A 21-year-old pregnant woman experiences frequent vomiting at 8 weeks gestation.
Abnormal thyroid function tests reveal suppressed TSH and elevated free T4. Differentiating
between transient gestational hyperthyroidism and Graves' disease is essential. Symptoms,
examination, and additional tests guide the diagnosis.
Pregnancy
Pg 17-23
Introduction
Hyperthyroidism is characterized by an overactive thyroid gland with elevated thyroid
hormones, including free thyroxine (free T4) and free triiodothyronine (free T3).
Thyrotoxicosis refers to the presence of symptoms along with elevated thyroid hormones.
Thyroid disorders can have significant implications for pregnancy outcomes. Graves' disease
is a common cause of thyrotoxicosis in pregnancy, while transient gestational
hyperthyroidism is a temporary condition. Accurate diagnosis is crucial for appropriate
management.
Case : Hyperthyroidism in Pregnancy
Abstract
Graves' disease frequently occurs in women of reproductive age and is a prevalent cause of
thyrotoxicosis in pregnancy, affecting about 0.15% of cases. Additionally, transient
gestational hyperthyroidism, observed in 2–3% of European pregnancies, can impact
pregnancy outcomes. Proper diagnosis is crucial for guiding management. This case study
discusses the presentation, diagnosis, and management of three common causes of
thyrotoxicosis during pregnancy and the postpartum period.
Keywords
Pregnancy • Thyrotoxicosis • Hyperthyroidism • Thyroiditis • Maternal • Gestational •
Graves' disease
Case 1: Overt Thyrotoxicosis – Pre-pregnancy
A 34-year-old woman with a history of primary infertility and recent miscarriage is referred
due to abnormal thyroid function tests (TFTs). She complains of palpitations and weight loss
after her miscarriage. Questions regarding the onset and duration of her symptoms, along
with additional signs of thyrotoxicosis, such as increased appetite, heat intolerance, tremor,
anxiety, and poor concentration, help evaluate her condition.
Examination reveals signs of thyrotoxicosis, including tachycardia, warm extremities, and
tremor. A thorough assessment helps identify her condition as Graves' thyrotoxicosis,
explaining her infertility. TFTs and thyroid antibodies confirm the diagnosis. Proper
management involves controlling thyroid function with propylthiouracil (PTU) and closely
monitoring her levels before considering pregnancy again.
Case 2: First-Trimester Hyperthyroidism
A 21-year-old pregnant woman experiences frequent vomiting at 8 weeks gestation.
Abnormal thyroid function tests reveal suppressed TSH and elevated free T4. Differentiating
between transient gestational hyperthyroidism and Graves' disease is essential. Symptoms,
examination, and additional tests guide the diagnosis.
