Which medication is generally recommended for pregnant patients with hyperthyroidism during the first trimester?

Propylthiouracil (PTU) is the medication typically recommended for pregnant patients with hyperthyroidism during the first trimester due to its favorable safety profile in pregnancy compared to other treatments. PTU is preferred because it has a lower risk of teratogenic effects when used during the early stages of pregnancy. While methimazole is effective for controlling hyperthyroidism, it has been associated with a higher incidence of congenital malformations if used during the first trimester.

Furthermore, radioactive iodine is contraindicated in pregnancy as it can harm the developing fetus, particularly the thyroid gland. Surgical removal of the thyroid gland is also considered a last resort and is generally avoided during pregnancy unless absolutely necessary due to the risks associated with surgery.

In summary, the use of propylthiouracil during the first trimester allows for the effective management of hyperthyroidism while minimizing risks to the developing fetus, making it the preferred choice in this clinical scenario.