Vaquero E, Lazzarin N, De Carolis C, Valensise H, Moretti C, Ramanini C
Department of Obstetric and Gynecology, University of Rome, Tor Vergata, Italy.
Am J Reprod Immunol. 2000 Apr;43(4):204-8. doi: 10.1111/j.8755-8920.2000.430404.x.
The aim of this study is to evaluate the role of mild thyroid abnormalities in recurrent spontaneous abortion, and to assess the effects of two different therapeutical protocols.
A prospective study in the population of recurrent aborters with mild thyroid abnormalities, evaluating the obstetric outcome in 42 patients. Sixteen thyroid autoantibodies positive patients were treated with thyroid replacement therapy, while 11 patients received intravenous immunoglobulins (IVIG). Fifteen patients, characterized by negative antithyroid antibodies, and having underlying thyroid pathology, were treated with thyroid replacement therapy.
Among patients with thyroid antibodies, 6 out of the 11 pregnancies (54.5%) treated with IVIG ended in live birth. In the thyroid supplementation group, 13 out of 16 pregnancies (81.2%) ended in live birth. Only one pregnancy loss occurred among patients with a mild underlying thyroid pathology treated with thyroid replacement therapy.
Mild thyroid abnormalities are associated with an increased rate of miscarriage. This poor obstetrical prognosis seems to be related to an impaired thyroid adaptation to pregnancy. Thyroid replacement therapy appears to be more effective than IVIG in preventing a new miscarriage.
本研究旨在评估轻度甲状腺异常在复发性自然流产中的作用，并评估两种不同治疗方案的效果。
对患有轻度甲状腺异常的复发性流产患者进行前瞻性研究，评估42例患者的产科结局。16例甲状腺自身抗体阳性患者接受甲状腺替代治疗，11例患者接受静脉注射免疫球蛋白（IVIG）治疗。15例甲状腺自身抗体阴性但有潜在甲状腺病变的患者接受甲状腺替代治疗。
在甲状腺抗体阳性患者中，接受IVIG治疗的11例妊娠中有6例（54.5%）活产。在甲状腺补充治疗组中，16例妊娠中有13例（81.2%）活产。接受甲状腺替代治疗的轻度潜在甲状腺病变患者中仅发生1例流产。
轻度甲状腺异常与流产率增加有关。这种不良的产科预后似乎与甲状腺对妊娠的适应性受损有关。甲状腺替代治疗在预防再次流产方面似乎比IVIG更有效。
