What is the treatment of choice for a pregnant patient with Graves' disease?

The treatment of choice for a pregnant patient with Graves' disease is Propylthiouracil (PTU). This medication is preferred during pregnancy, especially in the first trimester, because of its lower risk of teratogenic effects compared to methimazole. PTU is effective in controlling hyperthyroidism by inhibiting the synthesis of thyroid hormones, which is crucial in managing the condition during pregnancy to maintain both maternal and fetal health.

While methimazole is an effective treatment for hyperthyroidism, it has been associated with risks of congenital malformations if used in early pregnancy. Radioactive iodine is contraindicated during pregnancy because it can cross the placenta and may damage the fetal thyroid, potentially leading to hypothyroidism in the newborn. Thyroidectomy, while a treatment option in severe cases or when medication fails, is generally avoided in pregnancy unless absolutely necessary due to the risks involved in surgery during this delicate state. Therefore, PTU remains the safest option for managing Graves' disease in pregnant individuals.