Which treatment options are primarily used for a pregnant patient with hyperthyroidism?

In the case of hyperthyroidism during pregnancy, the primary treatment option is the use of medical therapy. Antithyroid medications, such as propylthiouracil (PTU) and methimazole, are commonly used to manage hyperthyroidism in pregnant patients. These medications help to lower thyroid hormone levels and can be safely administered during pregnancy, particularly in the first trimester when the risk of congenital malformations is lower with the use of PTU.

Radioactive iodine therapy is contraindicated in pregnant patients and is not a safe option since it can harm the developing fetus. Surgical resection of the thyroid may be considered in severe cases that do not respond to medical therapy; however, it is usually not the first-line treatment, especially if the patient can be managed effectively with medication. Deciding to wait until after pregnancy to treat hyperthyroidism may lead to maternal and fetal complications that could be avoided with appropriate medical therapy during pregnancy. Therefore, the use of medical therapy is favored as it allows effective management of hyperthyroidism while minimizing risks to both the mother and the fetus.