妊娠合并甲状腺功能减退症73例临床分析

Clinical analysis of hypothyroidism during pregnancy

目的:探讨妊娠合并甲状腺功能减退症(简称甲减)患者的妊娠结局、妊娠合并症及并发症。方法:选取2008年1月至2013年9月在我院就诊的73例妊娠合并甲减的患者,根据入院前是否接受过规范治疗分为治疗组46例和未治疗组27例,对其临床资料进行回顾性分析。结果:妊娠合并甲减患者流产发生率9.59%,早产发生率12.3%,死胎发生率1.37%,足月分娩率76.7%,剖宫产率43.1%;未治疗组流产、早产的发生率明显高于治疗组(P<0.05),剖宫产率明显高于治疗组(P<0.05)。妊娠合并症及并发症的发生率:妊娠合并贫血36.99%,妊娠期糖代谢异常17.81%,妊娠期高血压疾病9.59%,胎儿窘迫17.81%,产后出血5.48%,小于胎龄儿4.11%;未治疗组贫血、糖代谢异常、妊娠期高血压疾病、胎儿窘迫、产后出血的发生率显著高于治疗组(P<0.05)。结论:早期发现妊娠合并甲减患者并规范治疗可有效降低妊娠合并症及并发症的发生率,改善妊娠结局。

Objective： To investigate the pregnant outcome and complications of gravidas with hypothyroidism.Methods： Clinical data of 73 gravidas with hypothyroidism who delivered at Jiangyin Hospital from Jan. 2008 to Sep. 2013 were reviewed. They were divided into treated group and untreated group by standard treatment for hypothyroidism. Results： The incidence of miscarriage was 9. 59%,preterm birth was 12. 3%,fetal death was1. 37%,term birth was 76. 7%,cesarean delivery was 43. 1%; compared with treated group,the incidence of miscarriage,premature delivery and cesarean delivery in the untreated group was significantly higher（ P 〈 0. 05）.Pregnancy complications： the incidence of anemia was 36. 99%,abnormal glucose metabolism was 17. 81%,gestational hypertension was 9. 59%,fetal distress was 17. 81%,postpartum hemorrhage was 5. 48%,small for gestation age was 4. 11%; compared with treated group,the incidence of anemia,abnormal glucose metabolism,gestational hypertension,fetal distress,postpartum hemorrhage in the untreated group was significantly higher（ P 〈0. 05）. Conclusion： Early detection and standard treatment of gravidas with hypothyroidism can effectively reduce the incidence of pregnancy complications,and improve the pregnancy outcome.