{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:53:21Z","timestamp":1783482801247,"version":"3.55.0"},"reference-count":24,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":5102,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Risks to mother, fetus and neonate from untreated Graves\u2019 hyperthyroidism during gestation are compelling reasons for recommending pre-conception counselling. Pre-conception counselling should include discussion as to the optimum treatment of Graves\u2019 hyperthyroidism in women wishing to become pregnant. Thyrotropin receptor antibodies remain elevated following radioiodine therapy, so medical or surgical treatment may be preferred to avoid fetal or neonatal hyperthyroidism. A TSH level &amp;lt;2.5 mIU\/l must be achieved in women receiving LT&amp;lt;sub&amp;gt;4&amp;lt;\/sub&amp;gt; before conception. The patient should be reassured that both she and the fetus can be maintained in a euthyroid state and that neonatal hyperthyroidism can be readily managed with a good outcome. The risks of antithyroid drug therapy during gestation should be fully discussed with emphasis on the very low risk (although real) of liver disease with propylthiouracil treatment and embryopathy with methimazole or carbimazole therapy. While propylthiouracil is the preferred drug for the first trimester, if it is not available other thionamides may be given. Breast-feeding while on antithyroid drugs is not contraindicated provided the dose of drug is low. The patient should also be advised of the importance of thyroid monitoring in the post-partum period.<\/jats:p>","DOI":"10.1159\/000336102","type":"journal-article","created":{"date-parts":[[2012,4,18]],"date-time":"2012-04-18T03:46:27Z","timestamp":1334720787000},"page":"24-29","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":18,"title":["Pre-Conception Counselling in Graves\u2019 Disease"],"prefix":"10.1530","volume":"1","author":[{"given":"John H.","family":"Lazarus","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2012,2,29]]},"reference":[{"key":"2026070713013279200_ref1","doi-asserted-by":"crossref","unstructured":"Lazarus JH: Thyroid function in pregnancy Br Med Bull 2011;97:137\u2013148.","DOI":"10.1093\/bmb\/ldq039"},{"key":"2026070713013279200_ref2","unstructured":"Zuppa AA, Perrone S, Sindico P, Alighieri G, Antichi E, Carducci C, Romagnoli C: Fetal and neonatal outcomes in infants of mothers with TSH receptor antibody positivity in pregnancy. Pediatr Med Chir 2009;31:72\u201377."},{"key":"2026070713013279200_ref3","doi-asserted-by":"crossref","unstructured":"Tamaki H, Itoh E, Kaneda T, Asahi K, Mitsuda N, Tanizawa O, Amino N: Crucial role of serum human chorionic gonadotropin for the aggravation of thyrotoxicosis in early pregnancy in Graves\u2019 disease. Thyroid 1993;3:189\u2013193.10.1089\/thy.1993.3.189","DOI":"10.1089\/thy.1993.3.189"},{"key":"2026070713013279200_ref4","doi-asserted-by":"crossref","unstructured":"Kung AW, Jones BM: A change from stimulatory to blocking antibody activity in Graves\u2019 disease during pregnancy. J Clin Endocrinol Metab 1998;83:514\u2013518.10.1210\/jc.83.2.5149467567","DOI":"10.1210\/jc.83.2.514"},{"key":"2026070713013279200_ref5","doi-asserted-by":"crossref","unstructured":"Amino N, Izumi Y, Hidaka Y, Takeoka K, Nakata Y, Tatsumi KI, Nagata A, Takano T: No increase of blocking type anti-thyrotropin receptor antibodies during pregnancy in patients with Graves\u2019 disease. 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