妊娠期甲状腺毒症

H. Wright, D. Williams
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引用次数: 2

摘要

甲状腺毒症影响约1:500的育龄妇女。妊娠期未经治疗或控制不良的甲状腺毒症与显著的孕产妇和围产期发病率相关。妊娠期新发甲状腺毒症的识别和诊断可能具有挑战性,因为许多症状可能被错误地归因于正常妊娠的生理适应。妊娠剧吐(HG)的妇女通常有生化,但没有临床证据表明甲状腺毒症,不需要抗甲状腺药物(ATDs)治疗。对于患有临床甲状腺毒症的妇女,由于ATDs致畸风险的不确定性,导致了新的指南建议在妊娠期间使用ATDs。患有自身免疫性疾病(如1型糖尿病)和甲状腺过氧化物酶抗体(TPOAb)的妇女患产后甲状腺炎的风险增加,这可能导致永久性甲状腺功能减退。本综述总结了妊娠期甲状腺毒症的管理,并强调了仍缺乏结论性证据的争议领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THYROTOXICOSIS IN PREGNANCY
Thyrotoxicosis affects approximately 1:500 women of reproductive age. Untreated or poorly controlled thyrotoxicosis in pregnancy is associated with significant maternal and perinatal morbidity. Recognition and diagnosis of new onset thyrotoxicosis in pregnancy can be challenging as many of the symptoms can be misattributed to physiological adaptation of normal pregnancy. Women with hyperemesis gravidarum (HG) often have biochemical, but not clinical evidence of thyrotoxicosis, which does not need treatment with anti-thyroid drugs (ATDs). For women with clinical thyrotoxicosis, uncertainty regarding the risks of teratogenicity due to ATDs has led to new guideline recommendations for their use in pregnancy. Women with autoimmune diseases such as type I diabetes and who have thyroid peroxidase antibodies (TPOAb) are at an increased risk of developing postpartum thyroiditis, which can result in permanent hypothyroidism. This review summarises the management of thyrotoxicosis in pregnancy and highlights controversial areas for which conclusive evidence is still lacking.
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