胎儿甲状腺功能减退

Fetal Hypothyroidism

胎儿甲状腺功能减退 (胎儿甲减 )对胎婴儿有很多不利影响 ,如智力、精神运动能力障碍或减退 ,骨骼发育不良 ,严重时可引起克汀病。胎儿甲减的病因主要有先天性甲状腺功能减退 (CH)、药物性甲减、缺碘和母亲患自身免疫性甲状腺疾病 (AITD)。脐静脉血穿刺 (有经验的医师在 2 5～ 2 7周时穿刺是可行的 ,不良反应 <1%)测得TSH升高、FT4降低 ,超声检查示胎儿甲肿、发育迟缓、畸形 ,胎儿心动过缓可以诊断胎儿甲减[1～ 3 ] 。

Fetal hypothyroidism influences fetus and infant a lot including mental retardation, impaired psychomotor function, dysostosis and even cretinism. Major causes of fetal hypothyroidism are congenital hypothyroidism, drug-induced hypothyroidism, iodine-deficient hypothyroidism and maternal hypothyroidism because of autoimmune thyroid disease(AITD). It can be diagnosed by elevated serum TSH, decreased FT 4 (by puncture of umbilical vein which is safe by experienced physician in the 25th～27th week of gestation with adverse effect incidences below 1% ), fetal goiter, growth retardation, deformity and bradycardia.