妊娠合并甲状腺功能减退的诊断及治疗进展

Progress of diagnosis and treatment of pregnancy complicated hypothyroidism

甲状腺功能减退症是威胁育龄妇女健康的常见内分泌疾病,尤其在妊娠期,甲状腺处于应激状态,需分泌足量的甲状腺激素才能满足正常妊娠的需要,从而使非孕期甲状腺功能正常的孕妇处于代偿状态,导致部分妊娠妇女出现亚临床甚至明显的甲状腺功能减退情况。妊娠期甲状腺功能减退可分为妊娠期亚临床甲状腺功能减退和妊娠期临床甲状腺功能减退,也有一部分孕妇表现为妊娠期单纯低甲状腺素血症。孕妇严重的甲状腺功能减退症随访妊娠结局,但不良妊娠结局(妊娠期糖尿病、胎膜早破、妊娠期高血压疾病、早产、巨大儿)发生率高,而且还影响了胎儿神经智力发育[1]。因此,及时发现孕妇伴有甲状腺功能异常是孕期保健工作必不可少的部分,如进行早期宣传,对高危人群进行甲状腺功能筛查等。甲状腺功能低下早期发现并及时干预可以改善围产期结局,并减少对子代的不利影响。

Hypothyroidism is a common endocrine diseases threaten the health of women of childbearing age, especially during pregnancy, thyroid in a State of stress, need to secrete adequate amounts of thyroid hormones in order to meet the needs of normal pregnancy, so that the non-compensatory status in pregnant women with normal thyroid function during pregnancy, cause subclinical in some pregnant women and even apparent hypothyroidism conditions. Hypothyroidism in pregnancy can be divided into subclinical hypothyroidism in pregnancy and clinical hypothyroidism during pregnancy,some pregnant women also show for simple low thyroid hormone blood disease in pregnancy. Follow-up of severe hypothyroidism pregnancy outcomes in pregnant women,not only adverse pregnancy outcome （pregnancy diabetes, premature rupture of membranes, hypertensive disorder of pregnancy, prematurity, macrosomia） high incidence, but also affects the intellectual development of fetal nerem. Therefore, found that pregnant women with thyroid dysfunction in a timely manner is an essential part of health care during pregnancy, such as early publicity, high-risk screening for thyroid function, and so on. Hypothyroidism early detection and timely intervention can improve perinatal outcomes, and reduce the adverse effects on the offspring.