Ferraris Silvio, Valenzise Mariella, Lerone Margherita, Divizia Maria Teresa, Rosaia Lucia, Blaid Dario, Nemelka Odette, Ferrero Giovanni Battista, Silengo Margherita
Dipartimento di Scienze Pediatriche, Università di Torino, Turin, Italy.
Birth Defects Res A Clin Mol Teratol. 2003 Dec;67(12):989-92. doi: 10.1002/bdra.10098.
In hyperthyroidism-complicated pregnancies, medical therapy is necessary to reach an euthyroid condition, and propylthiouracil (PTU) or methimazole (MMI) are used. These drugs are equally effective, but may cause fetal and neonatal hypothyroidism because they freely cross the placenta. Although PTU has not been significantly associated with embryo-fetal anomalies, it has been suggested that MMI might be responsible for a specific embryopathy.
CASE(S): Two cases of major congenital anomalies after MMI exposure during pregnancy are reported.
PTU should be the drug of choice, and the use of MMI should be restricted to cases with allergic reactions, intolerance, or poor response to PTU.
在甲亢合并妊娠的情况下，必须进行药物治疗以达到甲状腺功能正常的状态，常用丙硫氧嘧啶（PTU）或甲巯咪唑（MMI）。这些药物疗效相当，但由于它们可自由通过胎盘，可能导致胎儿和新生儿甲状腺功能减退。虽然PTU与胚胎 - 胎儿畸形无显著关联，但有提示称MMI可能导致特定的胚胎病。
报告了两例孕期暴露于MMI后出现的严重先天性畸形病例。
PTU应作为首选药物，MMI的使用应仅限于对PTU过敏、不耐受或反应不佳的情况。
