Guideline sources The following summarized guidelines for the management of gestational transient thyrotoxicosis are prepared by our editorial team based on guidelines from the American Thyroid Association (ATA 2017). 1 2 2 2 3 3 Definition Gestational transient thyrotoxicosis refers to non-autoimmune hyperthyroidism in pregnant women, and is associated with hyperemesis gravidarum. 2 Epidemiology Gestational transient thyrotoxicosis is caused by alterations in thyroid function associated with pregnancy, such as elevation of thyroxine binding globulin, increased iodine clearance in kidneys, and stimulation of the thyroid gland by hCG. 2 Pathophysiology In Europe, the prevalence of gestational transient thyrotoxicosis at 8-14 weeks of pregnancy is estimated at 2-3%. In Asian women, the prevalence is higher and estimated at 11%. 3 Disease course Gestational transient thyrotoxicosis presents with signs and symptoms of hyperthyroidism and elevation of thyroid hormone in women with negative thyroid-receptor antibodies and no history of hyperthyroidism. 2 Prognosis and risk of recurrence https://web.pathway.md/diseases/recDnposPumjheM3P 1/2 6/24/23, 3:20 AM Gestational transient thyrotoxicosis Pathway Overt hyperthyroidism during pregnancy can lead to poor maternal and fetal outcomes. Maternal complications of pregnancy associated with hyperthyroidism include pre-term delivery, miscarriage, hypertension, and HF. The fetal and neonatal complications of maternal hyperthyroidism include goiter formation and hyperthyroidism, which can lead to intrauterine growth restriction and failure to thrive in the neonate. 3 Guidelines 1. Medical management Supportive care: provide supportive therapy, management of dehydration, and hospitalization if needed in women with abnormal maternal thyroid tests attributable to gestational transient thyrotoxicosis. B Antithyroid drugs: avoid using antithyroid drugs for the treatment of gestational transient thyrotoxicosis. D Beta-blockers: consider using -blockers if required for symptomatic relief in women with gestational transient thyrotoxicosis. B References 1. Erik K Alexander, Elizabeth N Pearce, Gregory A Brent et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27 3 315 389. Open 2. M Taha Albaar, John M F Adam. Gestational transient thyrotoxicosis. 2009 Apr;41 2 99 104.2009 Apr;41 2 99 104. Open 3. Artak Labadzhyan, Gregory A Brent, Jerome M Hershman et al. Thyrotoxicosis of Pregnancy. 2014 Dec 1;1 4 140 144.2014 Dec 1;1 4 140 144. Open https://web.pathway.md/diseases/recDnposPumjheM3P 2/2