Enfermedad de Graves en el embarazo: un enfoque en el manejo y complicaciones asociadas

Abstract

Graves' disease is the most common cause of hyperthyroidism during pregnancy. Although its prevalence is low, prompt management and timely follow-up is key. The diagnostic approach is made with thyroid function tests, reference ranges should be adjusted because of the physiological changes during pregnancy, added to this the identification of TSH receptor antibodies (TRAb) in maternal serum. Thionamide antithyroid drugs are the mainstay of treatment but during the different stages of pregnancy and the breastfeeding period there are aspects that must take into consideration before its use. The thyroidectomy may be indicated under very specific circumstances. Furthermore, Graves' disease can cause maternal, obstetric, fetal, and neonatal complications which are related to thyrotoxicosis, autoimmune phenomena and the effects of antithyroid drugs. Finally, postpartum follow-up is also essential to minimize the risk of relapse and associated morbidity.