Graves’ Disease in Pregnancy: A Systematic Review

Abstract

Introduction: Graves’ disease is an autoimmune disease that is associated with thyroid gland involvement and is most common in young women. During pregnancy, it is the main cause of hyperthyroidism, as the thyroid gland volume and thyroid hormone synthesis increase. Changes in the immune system during pregnancy can affect the onset of disease. During pregnancy, the pathological cause of Graves’ disease is immune deficiency. This study investigated changes in the thyroid gland occurring during pregnancy, the causes of Graves’ disease during pregnancy, and its diagnosis and treatment. Methods: A search of Google scholar, Ovid, and MEDLINE was conducted with the search terms Graves’ disease, pregnancy, and treatment. Results: A total of 65 titles were initially identified with the search strategy described. Twenty-five publications were excluded. Out of the remaining articles, 19 articles were used in terms of content. Treatment for Graves’ disease is determined according to the patient’s condition, the priority of the patient, and the resources available. Treatments include oral anti-thyroid drugs (ATDs), radioactive iodine, and surgical procedures. Among the oral prophylactic drugs, Propylthiouracil is used during lactation. Radioactive iodine is not used during pregnancy or lactation. Thyroidectomy is better to be used in the third trimester of pregnancy. Conclusion: The treatment of Graves’ disease is very important; if not treated, this disease causes many complications with the fetus. After delivery, the mother and the baby should be monitored for thyroid problems. Pre- and postpartum planning and the effective management of Graves’ disease in women of childbearing age are necessary to prevent the pathogenesis of Graves’ disease during pregnancy.