Division of Endocrinology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA.
Med Clin North Am. 2012 Mar;96(2):235-56. doi: 10.1016/j.mcna.2012.01.004.
Thyroid disorders are common in women during pregnancy. If left untreated, both hypothyroidism and hyperthyroidism are associated with adverse effects on pregnancy and fetal outcomes. It is important to correctly identify these disorders and treat them appropriately to prevent pregnancy-related complications. Levothyroxine is the indicated treatment for hypothyroidism, and thionamides are the treatment of choice for hyperthyroidism; thyroidectomy may be indicated in select cases. When thyroid cancer is diagnosed during pregnancy, a decision must be made regarding performing thyroidectomy during the pregnancy or postponing surgical resection until the postpartum period. Radioactive iodine is absolutely contraindicated during pregnancy and lactation.
甲状腺疾病在妊娠妇女中很常见。如果不进行治疗,甲状腺功能减退症和甲状腺功能亢进症都会对妊娠和胎儿结局产生不良影响。正确识别这些疾病并进行适当治疗以预防与妊娠相关的并发症非常重要。左甲状腺素是治疗甲状腺功能减退症的首选药物,硫脲类药物是治疗甲状腺功能亢进症的首选药物;在某些情况下可能需要进行甲状腺切除术。如果在妊娠期间诊断出甲状腺癌,则必须决定在妊娠期间进行甲状腺切除术还是推迟手术切除至产后。怀孕期间和哺乳期绝对禁忌使用放射性碘。