Updated February 09, 2015.

Why Can’t I Just Opt for Surgery in the First Place?

Surgical removal of the thyroid -- known as thyroidectomy -- may be necessary if you are pregnant and cannot tolerate antithyroid drugs, or if your hyperthyroidism is not being sufficiently managed with these medications. However, it’s only recommended as a first choice treatment option in women with specific circumstances.

If thyroid surgery is recommended for a pregnant woman, it may be because she:

• has an allergy to antithyroid drugs
• experienced side effects from antithyroid drugs
• needs extremely high doses of antithyroid drugs to manage her condition (i.e. more than 300 mg of PTU)
• her condition could not be managed by antithyroid drugs
• her fetus is showing evidence of hypothyroidism due to the antithyroid drugs (typically, a slow fetal heart rate, slowed bone development)

Surgery is typically performed in the second trimester (when the greatest risk of miscarriage has past.) Surgery is not typically performed in the third trimester, as this may pose a risk of pre-term labor and delivery.
After surgery, thyroid levels are still monitored carefully; antibody levels are also monitored during the later stages of pregnancy.

My Doctor Recommended I Take a Beta Blocker, Too. Should I Be Concerned?

Beta blockers may help with significant heart-related symptoms related to moderate-to-severe hyperthyroidism. Beta blockers are not considered safe for use during pregnancy for more than a short period of time.

Longer-term use during pregnancy is associated with various dangers to your unborn baby. Typically, doctors recommend that women use a beta blocker no more than two weeks, and they are most often given during the time when a woman is waiting for antithyroid drugs to take effect. They should also not be given toward the end of pregnancy, however, because they can be associated with growth problems, breathing difficulties, and slow heart rate in newborns.
Want to learn more? See UpToDate's topic, "Diagnosis and treatment of hyperthyroidism during pregnancy," for additional in-depth, current and unbiased medical information on name the condition/disease of relevance, including expert physician recommendations.

<sub>Source:

Ross, Douglas. "Diagnosis and treatment of hyperthyroidism during pregnancy." UpToDate. Accessed: February 2009.</sub>