A 28-year-old woman at 14 weeks of gestation attends the GP. She has a history of Graves' disease treated with carbimazole prior to conception. Her th...

Question

A 28-year-old woman at 14 weeks of gestation attends the GP. She has a history of Graves' disease treated with carbimazole prior to conception. Her thyroid function tests show: free T4 28 pmol/L (normal 12-22) and TSH

Accepted Answer

Continue carbimazole and refer urgently to endocrinology for dose optimisation using the lowest effective dose to maintain free T4 at or just above the upper limit of normal

Answer

Stop carbimazole immediately as it is teratogenic

Answer

Switch to radioiodine treatment

Answer

Switch to propylthiouracil for the remainder of the pregnancy

Answer

No treatment needed - mild hyperthyroidism is normal in pregnancy

uk-drcog MCQ (SBA): Hyperthyroidism - Carbimazole in Pregnancy