Maciel Léa Maria Zanini, Magalhães Patrícia K R
Divisão de Endocrinologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Arq Bras Endocrinol Metabol. 2008 Oct;52(7):1084-95. doi: 10.1590/s0004-27302008000700004.
Pregnancy is associated with an increased requirement of hormone secretion by the thyroid, within the first weeks after conception. To this greater demand to occurs, pregnancy induces a series of physiological changes that affect thyroid function and, consequently, the tests of glandular function. For normal pregnant women living in areas with a sufficient supply of iodine, this challenge regarding the adjustment of thyroid hormone releases to this new state of equilibrium and its maintenance until the end of pregnancy it meets no difficulties. However, among women with impaired thyroid function due to some thyroid disease or among women residing in areas with an insufficient iodine supply, this does not occur. The management of thyroid dysfunction during gestation requires special considerations, since both hypothyroidism and hyperthyroidism can lead to maternal and fetal complications. In addition, thyroid nodules are detected at reasonable frequency among pregnant women, a fact that requires a differential diagnosis between benign and malignant growths during the pregnancy itself.
怀孕与受孕后最初几周甲状腺激素分泌需求增加有关。为了满足这一更大的需求,怀孕会引发一系列影响甲状腺功能的生理变化,进而影响甲状腺功能测试。对于生活在碘供应充足地区的正常孕妇来说,在将甲状腺激素释放调整到这种新的平衡状态并维持到妊娠结束方面面临的这一挑战并不困难。然而,在因某些甲状腺疾病导致甲状腺功能受损的女性中,或者在碘供应不足地区居住的女性中,情况并非如此。孕期甲状腺功能障碍的管理需要特别考虑,因为甲状腺功能减退和甲状腺功能亢进都可能导致母婴并发症。此外,在孕妇中甲状腺结节的检出频率较高,这一事实要求在孕期本身就对良性和恶性生长进行鉴别诊断。