Department of Medical Endocrinology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Nat Rev Endocrinol. 2011 Mar 15;7(7):396-406. doi: 10.1038/nrendo.2011.34.
Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T(4) are the most consistent indication of maternal and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T(4) levels.
母体甲状腺药物过度治疗可诱发胎儿甲状腺肿性甲状腺功能减退症。这种情况会对妊娠结局、胎儿生长和神经发育产生严重影响。本综述旨在阐明胎儿甲状腺肿性甲状腺功能减退症是否可以预防，以及预防失败时应如何应对。了解治疗孕妇时与妊娠相关的母体甲状腺状态变化的重要性对于预防胎儿甲状腺肿性甲状腺功能减退症至关重要。游离 T4 水平是反映母体和胎儿甲状腺状态最可靠的指标。在胎儿甲状腺肿性甲状腺功能减退症患者中，羊膜内注射左甲状腺素可改善胎儿结局。避免母体甲状腺药物过度治疗的最佳方法是密切监测母体甲状腺状态，尤其是游离 T4 水平的估计值。
