Management of Hyperthyroidism in Pregnancy: Comparison of Recommendations of American Thyroid Association and Endocrine Society

Table 4

Comparison of recommendations of American Thyroid Association and Endocrine Society on other aspects of hyperthyroidism in pregnancy.

Topic	Recommendations
	American Thyroid Association (2011)	Endocrine Society (2012)
Management of; gestational hyperthyroidism	The appropriate management of women with gestational hyperthyroidism and hyperemesis gravidarum includes supportive therapy, management of dehydration, and hospitalization if needed.; ATDs are not recommended for the management of gestational hyperthyroidism.; Same (T)	Most women with hyperemesis gravidarum, clinical hyperthyroidism, suppressed TSH, and elevated free T4 do not require ATD treatment. Clinical judgment should be followed in women who appear significantly thyrotoxic or who have in addition serum total T3 values above the reference range for pregnancy. Beta blockers such as metoprolol may be helpful and may be used with obstetrical agreement.; Women with hyperemesis gravidarum and diagnosed to have Graves’ hyperthyroidism (free T4 above the reference range or total T4 > 150% of top normal pregnancy value, TSH < 0.01 mIU/liter, and presence of TRAb) will require ATD treatment, as clinically necessary.
Subclinical hypothyroidism	Same (T)	There is no evidence that treatment of subclinical hyperthyroidism improves pregnancy outcome, and treatment could potentially adversely affect fetal outcome.