What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient?

In a 10-week pregnant patient diagnosed with hyperthyroidism, the initial treatment of choice is Propylthiouracil (PTU).

PTU is preferred during the first trimester of pregnancy due to its lower risk of teratogenic effects compared to other antithyroid medications. While methimazole is often used in non-pregnant patients as it is more effective and easier to manage, its use in early pregnancy is associated with a higher risk of congenital anomalies. Therefore, PTU is specifically recommended until after the first trimester when the risk of teratogenicity decreases, and methimazole can then be considered for continued management.

The other options, such as radioiodine treatment and subtotal thyroidectomy, are not appropriate initial treatments during pregnancy. Radioiodine is contraindicated in pregnant patients due to the potential for radiation exposure to the fetus, which can cause harm to the developing thyroid. Subtotal thyroidectomy is generally reserved for cases of severe hyperthyroidism that do not respond to medical management, or when there are concerns about compliance or adverse effects from medications. However, surgery is not typically the first-line treatment option during the first trimester due to the risks associated with surgery and anesthesia during early pregnancy.

Given these considerations,