Neonatal Thyroid Function after Propylthiouracil Therapy for Maternal Gravesʼ Disease

Cheron, Robert G.; Kaplan, Michael M.; Larsen, P. Reed; Selenkow, Herbert A.; Crigler, John F.

doi:10.1097/00006254-198109000-00002

Cited by 3 publications

(6 citation statements)

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“…In addition to fetal hypothyroidism and the development of fetal goiter, the use of PTU and MMI has been reported to be associated with congenital anomalies including muscular hypotonicity10, cryptorchidism10, aortic atresia11, hypospadias11, congenital dislocation of the hip12, aplasia cutis congenita7, choanal atresia13 and syndactyly14. However, no effect on long‐term cognitive or somatic development has been found in infants exposed in utero to ATDs15, 16.…”

Section: Discussionmentioning

confidence: 99%

Exploration and Optimization of Structure–Activity Relationships in Drug Design using the Taguchi Method

et al. 2012

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From engineering to drug design: Use of the Taguchi method to predict the optimal compound from a dataset could potentially allow the identification of the most biologically active compound without the synthesis of a full combinatorial library of derivatives. Our results show that the method achieved favorable outcomes for biological activities that are measured against specific target proteins. However, limitations were observed when the method was applied to data derived from a cell‐based system.

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Section: Discussionmentioning

confidence: 99%

Exploration and Optimization of Structure–Activity Relationships in Drug Design using the Taguchi Method

et al. 2012

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“…The accuracy of the drug histories provided by these mothers cannot be verified since no drug screens were performed." Greenland et al performed a careful study to compare preg- 190 1984 MAR VOL 18 Drug Intelligence and Clinical Pharmacy nancy outcome among marijuana users and a control group. The marijuana smokers used tobacco and alcohol more frequently than did the controls.…”

Section: Marijuana Usementioning

confidence: 99%

“…[190][191][192] In addition, neonatal hyperthyroidism may occur five to ten days after birth as the antithyroid drugs are eliminated. This appears particularly likely in the offspring of mothers with elevated long-acting thyroid stimulator (LATS).193 Limited information on the development of infants exposed in utero to PTU suggests that no problems occur,181.l92.…”

Section: Thyroid and Antithyroid Therapymentioning

confidence: 99%

Fetal Drug Exposure—Behavioral Teratogenesis

Gál¹,

Sharpless²

1984

Drug Intelligence & Clinical Pharmacy

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This paper reviews the neurobehavioral and developmental effects of fetal drug exposure. The drugs most commonly associated with adverse developmental outcome include alcohol, anticonvulsants (particularly phenytoin and trimethadione), narcotics, and some environmental toxins. Major limitations of studies examining the consequences of prenatal drug exposure on development include inadequate control of other confounding factors, uncertain accuracy of drug histories, and outcome criteria that provide insufficient delineation of subtle developmental delays.

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“…Because of Graves' Disease and Pregnancy DOI: http://dx.doi.org/10.5772/intechopen.97640 the expected immunosuppression during the second and third trimester, a partial and transient remission of Grave's disease may occur and appropriate reduction of the dose or even discontinuation of ATD could be done. Otherwise excessive doses of ATDs, indeed, may affect fetal thyroid function, with the development of hypothyroidism and/or goiter [68,69]. Relapse of the hyperthyroidism is frequent in postpartum period [70].…”

Section: Treatmentmentioning

confidence: 99%

“…Because both PTU and MMI can cross the placenta and they may decrease fetal thyroid hormone production The dose-response relationship between maternal ATD dose and neonatal thyroid function is controversial, as some studies have Graves' Disease and Pregnancy DOI: http://dx.doi.org/10.5772/intechopen.97640 reported a direct correlation [66,69,80] and others have not demonstrated this [64,69,73]. There are data showing that ATD drugs even at low daily dosages (PTU ≤ 100 mg, MMI ≤ 10 mg) at term may affect the fetal thyroid function.…”

Section: Antithyroid Drugs: Effect On the Fetusmentioning

confidence: 99%

Graves' Disease and Pregnancy

1981

N Engl J Med

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Graves' disease is an autoimmune organ specific disease characterized by excessive production of hormones from the thyroid gland and by its diffuse enlargement. The growth and function of the thyroid gland are stimulated by autoantibodies directed against the thyroid-stimulating hormone receptor. Pregnancies complicated by Graves' disease are characterized with higher incidence of abortion, preterm delivery, low-birth-weight infants and neonatal mortality, as well as maternal complications such as heart failure, eclampsia and rarely thyroid storm. When fully controlled hyperthyroidism have excellent outcomes. Different therapeutic approaches are used in women with Graves' planning pregnancy and in those when the disease is diagnosed after they became pregnant. Thionamides are the first choice for treatment, with Propylthyouracil being preferred for the first trimester and Methimazole for the second and third trimester. Aplasia cutis and some other malformations were associated with methimazole use during pregnancy. Monitoring the effect of treatment should ensure keeping maternal FT4 in the high normal range. Block-and replace regimen is not recommended and rdioiodine therapy is absolutely contraindicated. Thyroidectomy may be considered before pregnancy or in rare cases in the second trimester. Iodine is avoided because of the risk of fetal hypothyroidism and goiter. The use of beta-blockers is controversial. Noenatal thyrotoxicosis may occur in association with maternal Graves' disease due to maternal TSAbs cross through the placenta.

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Neonatal Thyroid Function after Propylthiouracil Therapy for Maternal Gravesʼ Disease

Cited by 3 publications

References 0 publications

Exploration and Optimization of Structure–Activity Relationships in Drug Design using the Taguchi Method

Exploration and Optimization of Structure–Activity Relationships in Drug Design using the Taguchi Method

Fetal Drug Exposure—Behavioral Teratogenesis

Graves' Disease and Pregnancy

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