propylthiouracil and Abortion--Spontaneous

The purpose of this meta-analysis was to assess the safety of the anti-thyroid drugs (ATDs) propylthiouracil (PTU) and methimazole (MMI) in the treatment of hyperthyroidism during pregnancy.. From inception until June 2, 2022, all available studies were searched in PubMed, Web of Science, Cochrane, EBSCO, Embase, Scopus, and CNKI.. Thirteen articles satisfying the inclusion criteria were examined. Our meta-analysis indicated that pregnant women treated with MMI had a higher risk of congenital anomalies than those treated with PTU (OR 0.80, 95%CI 0.69-0.92, P = 0.002, I2 = 41.9%). Shifting between MMI and PTU during pregnancy did not reduce the risk of birth defects compared to PTU alone (OR 1.18, CI 1.00 to 1.40, P = 0.061, I2 = 0.0%). There were no statistically significant differences in hepatotoxicity (OR 1.54, 95%CI 0.77-3.09, P = 0.221, I2 = 0.0%) or miscarriage (OR 0.89, 95%CI 0.72-1.11, P = 0.310, I2 = 0.0%) between PTU and MMI exposure.. The study confirmed propylthiouracil is a safer alternative to methimazole for treating hyperthyroidism in pregnant women, and it is appropriate to treat maternal thyroid disease with PTU during the first trimester of pregnancy. However, it is not clear whether switching between propylthiouracil and methimazole is a better option than treating PTU alone during pregnancy. Further studies on this matter may be needed to develop new evidence-based guidelines for the treatment of pregnant women with hyperthyroidism.

Topics: Abortion, Spontaneous; Antithyroid Agents; Female; Humans; Hyperthyroidism; Methimazole; Pregnancy; Pregnancy Complications; Propylthiouracil

Topics: Abortion, Spontaneous; Adult; Antithyroid Agents; Autoantibodies; Diabetes Mellitus, Type 1; Diabetes, Gestational; Female; Fertilization in Vitro; Gestational Age; Graves Disease; Humans; Hyperthyroidism; Hypothyroidism; Infant, Newborn; Infertility, Female; Iodine; Male; Menstrual Cycle; Menstruation Disturbances; Pregnancy; Pregnancy Complications; Prevalence; Propylthiouracil; Puerperal Disorders; Risk Factors; Thyroid Diseases; Thyroid Gland; Thyroid Hormones; Thyroiditis; Thyrotropin; Thyroxine; Ultrasonography

Topics: Abortion, Spontaneous; Female; Fetal Diseases; Humans; Hyperthyroidism; Hypothyroidism; Maternal-Fetal Exchange; Methimazole; Pregnancy; Pregnancy Complications; Propylthiouracil; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Thyroidectomy; Thyrotropin-Releasing Hormone; Thyroxine

Topics: Abortion, Spontaneous; Congenital Hypothyroidism; Female; Fetal Death; Humans; Hyperthyroidism; Infant, Newborn; Infant, Newborn, Diseases; Intellectual Disability; Methimazole; Pregnancy; Pregnancy Complications; Propylthiouracil; Thyroidectomy; Triiodothyronine

Whether radioactive iodine treatment of Graves' disease (GD) during pregnancy will increase pregnancy loss and affect fetal development is still a matter of concern. From May 2005 to December 2015, 2,276 childbearing-age women with GD received iodine-131 treatment in our departments and were retrospectively enrolled in our study. When some of them were found to have been pregnant, their thyroid functions were measured every 4 weeks, in addition, thyroid-stimulating hormone (TSH) was measured 6 weeks after delivery. When necessary, levothyroxine or propylthiouracil (PTU) was given in order to control their TSH levels during pregnancy. Finally, 69 pregnant women (29 ± 3.5 years old) and 1346 women who were not pregnant during the follow-up period were enrolled into this study. They were all hyperthyroid before or during pregnancy. Among 69 pregnant women, the administrated amount of iodine-131 was 254.9 ± 99.9 MBq. Fifty patients became subclinically hypothyroid after treatment and were administrated levothyroxine (55 ± 25 μg/d). Seven patients were diagnosed with subclinical hyperthyroidism during pregnancy and they received PTU (25 ± 12.5 mg/d). Twelve patients with normal thyroid function were also clinically followed. Among 69 women, 63 had a single birth, 3 had dizygotic twins, 2 had two pregnancies and 1 had a single twin birth. Sixty five babies were born full-term, while 9 were premature (4 ± 1 weeks early) with birth weight 3.2 ± 0.5 kg. Six new born babies were considered to be low birth weight infants (< 2.5 kg) while 5 were high birth weight (> 4 kg), but the weights of all the infants were within the normal range. During the period of observation to December 2015, all the infants were found to grow and develop normally. Among 1346 women who were not pregnant were in the further follow-up. Our study found no detrimental effects of the iodine-131 treatment in the pregnant women or their offspring so far.

Topics: Abortion, Spontaneous; Adult; Female; Fetal Development; Graves Disease; Humans; Iodine Radioisotopes; Maternal Exposure; Pregnancy; Prenatal Exposure Delayed Effects; Propylthiouracil; Retrospective Studies; Sex Ratio; Thyrotropin; Thyroxine

Topics: Abortion, Spontaneous; Administration, Oral; Animals; Animals, Newborn; Drugs, Chinese Herbal; Eating; Female; Fertility; Fetal Development; Gestational Age; Male; Pregnancy; Prenatal Exposure Delayed Effects; Propylthiouracil; Rats, Sprague-Dawley; Reproduction; Risk Assessment; Tablets; Time Factors; Toxicity Tests, Chronic; Weight Gain

Topics: Abortion, Spontaneous; Adult; Antithyroid Agents; Carbimazole; Female; Gestational Age; Heart Rate, Fetal; Humans; Hyperemesis Gravidarum; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Propylthiouracil; Recurrence; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine

Topics: Abortion, Spontaneous; Female; Humans; Hyperthyroidism; Pregnancy; Pregnancy Complications; Propranolol; Propylthiouracil; Thyroxine; Triiodothyronine

Presented are two case studies which investigate the adverse effects of Graves' disease in pregnant women. Particular attention has been paid to the therapeutic regimen and its implications for the maternal, fetal and neonatal well-being. The first case study illustrates that Graves' disease complicating pregnancy can be treated by bed rest and careful observation of mother and fetus. The first pregnancy of our second case study confirms these results. Her second pregnancy, in which the symptoms of Graves' disease were far more severe, illustrates that it is possible to treat fetal hyperthyroidism by treating the pregnant mother with antithyroid drugs. If great care is taken to avoid overtreatment of the fetus, the treatment with antithyroid drugs is superior to surgical treatment, since surgery completely neglects the problem of fetal hyperthyroidism.

Topics: Abortion, Spontaneous; Adult; Female; Fetal Diseases; Graves Disease; Humans; Hypothyroidism; Intellectual Disability; Pregnancy; Pregnancy Complications; Propylthiouracil

Twenty-one women were studied who had received propylthiouracil or methimazole during 26 pregnancies. Four of the infants had a goiter at birth, and 3 of these had neonatal thyrotoxicosis. In 2 children neonatal thyrotoxicosis was not evident at birth because of maternal antithyroid therapy. Five children had congenital defects. Two mothers were responsible for 4 of the children with abnormalities, and both mothers had been treated with thiourea drugs for long periods, ranging from 7 to 11 years. The majority of children who are exposed to these drugs in utero appear to have no subsequent ill effects. However, prolonged therapy with these agents may be undesirable.

Topics: Abnormalities, Drug-Induced; Abortion, Spontaneous; Adult; Female; Fetal Blood; Fetal Death; Goiter; Humans; Hyperthyroidism; Infant; Infant, Newborn; Infant, Newborn, Diseases; Long-Acting Thyroid Stimulator; Male; Methimazole; Pregnancy; Pregnancy Complications; Propylthiouracil; Scalp; Thyroid Function Tests; Thyroxine

Topics: Abortion, Spontaneous; Antithyroid Agents; Basal Metabolism; Female; Humans; Hyperthyroidism; Infant, Newborn; Iodine Radioisotopes; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications; Propylthiouracil; Thyroidectomy; Thyroxine; Triiodothyronine

Topics: Abortion, Spontaneous; Adolescent; Adult; Cesarean Section; Cholesterol; Female; Fetal Death; Gestational Age; Goiter; Humans; Hyperthyroidism; Infant, Newborn; Iodine; Iodine Radioisotopes; Maternal Mortality; Methimazole; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Propylthiouracil; Thyroid Function Tests; Thyroid Hormones; Thyroidectomy; Triiodothyronine