A 29-year-old woman at 14 weeks gestation presents for prenatal care. She reports a 3-week history of palpitations, anxiety, and heat intolerance. Vital signs show heart rate 105 bpm and blood pressure 132/80 mmHg. Laboratory studies reveal TSH 0.1 mIU/L, free T4 2.8 ng/dL, and thyroid-stimulating immunoglobulin is positive. Which of the following is the appropriate first-line treatment?
- A)Beta-blockade alone without antithyroid drugs
- B)Radioactive iodine ablation
- C)Propranolol for symptom control and propylthiouracil for antithyroid effectGABARITO
- D)Levothyroxine to suppress TSH and prevent fetal goiter
- E)Methimazole monotherapy throughout pregnancy
Explicação
In pregnancy, particularly the first trimester, propylthiouracil (PTU) is preferred over methimazole because methimazole is associated with methimazole embryopathy (including aplasia cutis, esophageal atresia, and choanal atresia). Propranolol provides symptom... Ver explicação completa e trilha adaptativa →