A 35-year-old woman at 12 weeks gestation presents with thyroid eye disease, tremor, and palpitations. Vital signs show HR 102 bpm, BP 138/88 mmHg, RR 18, temp 37.2°C. Labs reveal suppressed TSH 0.1 mIU/L, elevated free T4 2.5 ng/dL, and positive TSH receptor antibodies. She denies recent iodine exposure. Which antithyroid agent carries the lowest risk of congenital anomalies during the first trimester?
- A)Iodine solution (Lugol or SSKI)
- B)Methimazole
- C)Propranolol alone
- D)Atenolol alone
- E)PropylthiouracilGABARITO
Explicação
Propylthiouracil (PTU) is preferred in the first trimester because methimazole is associated with methimazole embryopathy (methimazole-induced cutaneous aplasia, choanal atresia, esophageal atresia). PTU has less placental transfer, though both cross the place... Ver explicação completa e trilha adaptativa →