Luton D, Ducarme G, Vuillard E, Polak M
Service de maternité, hôpital Robert-Debré, APHP, université Paris-VII, 48, boulevard Sérurier, 75019 Paris, France.
Gynecol Obstet Fertil. 2007 Jan;35(1):60-5. doi: 10.1016/j.gyobfe.2006.11.002. Epub 2006 Dec 29.
Association between thyroidian disease and pregnancy is a frequent event. Thyroidian hormones are mandatory for foetal development especially at the level of brain structures. Any shortage of thyroidian hormone can severely and irreversibly alter neurological development. On the other hand it is also clear that an excess of thyroidian hormone can jeopardize the embryo then the foetus. In case of maternal hyperthyroidism, strict guidelines relying mainly on foetal thyroid monitoring echographic scanning will allow in most cases the delivery of a healthy euthyroid newborn. Hypothyroidia, providing an adequate substitution, has no significant impact on pregnancy. Biological monitoring is the key of monitoring. Iodine deficiency is a matter of concern when considering neurodevelopmental outcome, however it is still an unsolved issue in France. A multidisciplinary team will sometimes be necessary for taking care of pregnant patients with active Graves' disease.
甲状腺疾病与妊娠之间的关联是常见情况。甲状腺激素对胎儿发育至关重要,尤其是在脑结构发育层面。甲状腺激素的任何短缺都可能严重且不可逆地改变神经发育。另一方面,甲状腺激素过量也显然会危及胚胎进而危及胎儿。在孕妇甲状腺功能亢进的情况下,主要依靠胎儿甲状腺监测超声扫描的严格指导方针在大多数情况下能确保娩出健康的甲状腺功能正常的新生儿。甲状腺功能减退症在给予充分替代治疗时,对妊娠没有显著影响。生物学监测是监测的关键。考虑到神经发育结局时,碘缺乏是一个值得关注的问题,然而在法国这仍是一个未解决的问题。有时需要一个多学科团队来照料患有活动性格雷夫斯病的孕妇。