妊娠期甲状腺功能减退产妇分娩结局及产科并发症临床分析

Maternity and Obstetric Complications Result of Hypothyroidism during Pregnancy

目的探究妊娠期甲状腺功能减退(甲减)产妇的分娩结果及产科并发症发生情况。方法选取2013年1月至2014年1月来青岛市胶州中心医院产科收治的80例妊娠期合并甲减患者作为观察组;另选取同期行孕期检查的80例正常妊娠妇女作为对照组。检测两组产妇孕早、中、晚期及产后血中促甲状腺激素(TSH)的浓度变化情况,比较两组产妇的的分娩结果及产科并发症发生情况。结果对照组产妇孕早、中、晚期及产后1周的TSH浓度分别为(1.21±0.04)、(2.25±0.32)、(2.90±0.36)、(1.39±0.03)m U/L,观察组分别为(2.73±0.12)、(6.33±0.15)、(8.04±0.22)、(7.52±0.62)m U/L,两组产妇不同时间点血TSH浓度比较差异有统计学意义(P<0.05)。观察组产妇剖宫产率、早产率、自发性流产率及围生儿病死率分别为70.0%(56/80)、17.5%(14/80)、15.0%(12/80)、12.5%(10/80),均高于对照组的47.5%(38/80)、3.9%(3/80)、2.5%(2/80)、1.3%(1/80)(P<0.05);观察组产科并发症的总发生率显著高于对照组[32.5%(26/80)比8.8%(7/80)],差异有统计学意义(P<0.05)。结论妊娠期甲减产妇孕期及产后TSH水平较高,且不良分娩结果及产科并发症的发生率也较高,应定期监测,做到早诊断、早治疗,利于改善妊娠期甲减产妇的妊娠结局。

Objective To explore hypothyroidism during pregnancy and childbirth result of maternal obstetric complications. Methods From Jan. 2013 to Jan. 2014 in Qingdao Jiaozhou Central Hospital 80 patients with hypothyroidism during pregnancy were included as an observation group;another 80 eases of normal pregnancy during the same period were＇ included as a control group. The early, middle,late and post- natal blood thyroid stimulating hormone（TSH） concentrations changes were detected, and the maternal and obstetric complications were compared. Results The early,middle,late,and 1 week postpartum TSH concen- trations of the control group were （ 1.21 ± 0：04 ）, （ 2. 25 ± 0. 32 ）, （ 2. 90 ± 0. 36 ）, （ 1.39 ± 0. 03 ） mUlL respectively,of the observation group were （2.73 ±0. 12）, （6. 33 ±0. 15 ）, （8.04 ±0. 22）, （7.52 ±0. 62） mU/L respectively, the differences of blood TSH concentration at different time points between the two groups were statistically significant（ P 〈 0. 05 ）. The Cesarean section rate, the premature delivery rate, spontaneous abortion and perinatal child mortality rate of the observation group were 70. 0% （56/80）, 17.5% （ 14/80）, 15.0% （ 12/80）, 12.5% （10/80） respectively, of the control group were 47.5 % （38/80） ,3.9% （3/80）, 2. 5 % （2/80）, 1.3 % （ I/80 ） respectively, the observation group were significantly higher （ P 〈 0. 05 ） ; the overall obstetric complications incidence of the observation group was significantly higher than the control group [ 32. 5 % （26/80） vs 8. 8 % （7/80） ] （ P 〈 0. 05 ）. Conclusion Higher pregnant and postpartum TSH levels and incidence of adverse childbirth results and obstetric complications are observed in pregnancy complicated with maternal hypothyroidism, so regular monitoring should be performed to realize early diagnosis and early treatment, which will help improve the pregnancy outcome of patients of pregnancy complicated with hypothyroidism.