妊娠合并甲状腺功能亢进22例临床分析

Clinical analysis of 22 cases of pregnancy complicated with hyperthyroidism

目的 分析妊娠合并甲状腺功能亢进患者孕期病情变化 ,评价其对妊娠结局的影响。方法 对2 2例妊娠合并甲状腺功能亢进病例作回顾性分析。结果 2 2例中除 8例原甲状腺功能亢进未复发或加重 ,无明显甲状腺功能亢进症状外 ,其余 14例孕期均发生显著的甲状腺功能亢进症状。前 8例患者无明显母婴异常。后 14例中初发和加重各 3例 ,复发 8例 ;孕早期发病 5例 (35 .71% ) ,孕中晚期发病 9例 (6 4.2 9% ) ;3例 (2 1.43% )早产 ,6例 (4 2 .86 % )发生胎儿宫内生长迟缓 (IUGR) ,4例 (2 8.5 7% )发生胎盘功能低下 ;而且这 14例新生儿中发生窒息 4例 (2 8.5 7% ) ,发生新生儿甲状腺功能亢进、甲状腺功能减退、足月低体重儿各 1例 (7.14% )。结论 妊娠各期均可能发生甲状腺功能亢进或使其复发或加重 ,尤其多见于孕中、晚期 ;甲状腺功能亢进可导致不良妊娠结局 ,并对胎儿及新生儿产生不良影响 ,所以妊娠合并甲状腺功能亢进孕期应及时治疗 ,加强监护。

Objective To study the changes of thyroid function of pregnancy complicated with hyperthyroidism during gestation and the influence on the outcome of their pregnancies. Methods Clinical data of 22 cases of pregnancy complicated with hyperthyroidism from 1993 to 1998 were analyzed retrospectively.Results In these 22 cases, 14 had overt clinical symptoms, including 3 primary cases, 8 recurrent and 3 aggravated ones, 5 cases (35.71%) occurred in early gestation, 9 (64.29%) in later gestation, 3 cases (21.43%) during premature labor, 6 with (42.86%) IUGR, 4 (28.57%) with placenta dysfunction, 4 (28.57%) with neonatal asphyxia, 1 each with (7.14%) neonatal hyperthyroidism, neonatal hypothyroidism and low weight. The thyroid function of the remaining 8 cases showed no changes. Conclusion The symptoms of hyperthyroidism can be induced, recurred or worsened during every gestation, especially in the middle and late gestations. Pregnancy complicated with hyperthyroidism can result in bad outcome of pregnancy, in particular, the effect on the fetus and the neonate. Hence,they should be treated early and monitored in follow up.