Graves Disease and Pregnancy?

[sandygirl]

I have graves disease {a form of hyperthyroid} that was undiagnosed during my last pg. It was discovered at 12mo pp presenting at thyroid storm. That was 6 months ago, and it's fairly well controlled now.

I'm on methimazole {10mg 3x daily} and Propranolol {40mg 3x daily}, to control it, currently waiting on a endocrinologist referral to better control it. I am debating TTC #2, and know that graves does have side effects during pregnancy, as does the drug I am taking for it.

What would be your counsel as to thinking about TTC? Would this risk me out for a homebirth? I'm really on the edge as I know the medication can cause a few specific birth defects, but the studies I've read are conflicting and my OB {Planned Parenthood} won't say anything other than I should consider myself done with having children, and stay on a reliable form of birth control.

I know this a a long shot, but I'd really like to know if having another is a possibility

[JamSamMom]

I got pregnant with #1 with graves disease. I was put on PTU by my endocrinologist which is the safest medicine to treat graves during pregnancy and breastfeeding. It is also at the time (2003) the only medicine you can use during pregnancy for graves. So if your endo. can swith you and regulate you on PTU the you can get pregnant! The side effects for PTU are liver damage, weakened immune system, blood clotting disorders. So I had my blood drawn monthly but the main concern with graves and pregnancy was premature delivery so being regulated was very important. MY OB and endocrinologist had many patients on PTU during pregnancy and the only side effect to the baby was a goiter or depressed thyroid which goes away after delivery and rarely interferes with breastfeeding. So I had a pediatrician in my delivery and follow up in the hospital. I did work full time 12 hour shifts during pregnancy in labor and delivery as a nurse....I was tired and once my HR was in the 130's and I had to take a break for 20 minutes before it went down but otherwise I was fine. The pediatrician and NICU doctors encouraged me to breastfeed and said to have my daughters blood drawn after delivery with the cord blood and then before discharge and then at two weeks and the one month and then two months. So at birth and a few days later her thyroid was supressed so I had to quit breastfeeding because PTU was the safest medicine and there was no alternative. So formula feeding was the only bad thing that happened. I did do radioactive iodine therapy at 4 months PP and then had to wait 6 monhts to TTC but it took 2 years and one miscarriage to get regulated on synthroid after the radioactive iodine therapy made me hypothyroid. Anyway I would say yes you can get pregnant again but you may need radioactive iodine therapy if you can not take PTU. Good luck and don't give up hope!!! PM me if you have any questions would love to help you I would hate to think people are just writing you off like that waying you should never get pregnant.

[sandygirl]

jamsammom - thanks. I'm allergic to the iodine, and PTU doesn't work for me so my options are methimazole or surgery {not willing to do right now}

did the graves risk you out a a home birth? I won't TTC at all if I can't have a HB as the hospitals are so bad locally.

[JamSamMom]

Sandygirl, I am sorry to hear you can't do radioactive iodine or PTU. Looks like surgery may be the best choice for you but then you would probably become hypothyroid and need synthroid. I never looked into a HB when I was pregnant I was living in Okinawa Japan and HB were not allowed in base housing at the time. I went to a midwife who was actually the senior officer in charge of L&D at the naval hospital and when she was on vacation around my 16th week checkup I saw an OB and the doctor said I was high risk and could not go to a midwife or Nurse practitioner. So I was saw the OB and the high risk MD for the rest of my pregnancy. Although if I went into labor I got whoever was on call so if the midwife was on call he or she would have delivered me. So I think I could have had a home birth because my HR was 100's -120's at delivery and my BP was 90's -100's systolic.

I think if you do get pregnant you would need to keep an open mind if your HR or BP are out of control you may need a hospital delivery for your health and the child. If your HR is above 140 then the baby will get less blood flow to the placenta which could be very bad. My HR did not go above 130 during pregnancy. My resting HR was in the 100's and up to 120's with activity. I do not think anyone could guarantee you a HB it would be a wait and see type of situation. If your HR and BP remained stable during pregnancy and a midwife was comfortable monitoring your vitals during labor then you could but you would need to keep an open mind about the possibility of being transfered to a hospital.