Porreco R P, Bloch C A
AMI St. Luke's Perinatal Program, Denver, Colorado.
Obstet Gynecol. 1990 Sep;76(3 Pt 2):509-12.
Graves disease is an autoimmune disorder caused by thyroid-stimulating immunoglobulins (Igs) which result in an excess production of thyroid hormones. These Igs are passively transferred to the fetus and may produce intrauterine thyrotoxicosis. Thyrotoxic fetuses are at risk for preterm delivery, intrauterine growth retardation, and perinatal death. Our patient had markedly elevated thyroid-stimulating Igs and had given birth to a preterm thyrotoxic infant in a previous pregnancy. We managed her third pregnancy with serial assessment of fetal thyroid hormones by funipuncture to identify the hyperthyroid fetus and modulate propylthiouracil therapy. We believe that this approach in selected patients with Graves disease may improve the outcome of these pregnancies.
格雷夫斯病是一种自身免疫性疾病，由促甲状腺免疫球蛋白（Igs）引起，导致甲状腺激素分泌过多。这些免疫球蛋白会被动转移至胎儿体内，并可能导致胎儿宫内甲状腺毒症。甲状腺毒症胎儿有早产、宫内生长受限和围产期死亡的风险。我们的患者促甲状腺免疫球蛋白显著升高，且曾在前次妊娠中分娩出一名早产甲状腺毒症婴儿。我们通过脐血穿刺对其第三次妊娠进行胎儿甲状腺激素的系列评估，以识别甲状腺功能亢进胎儿并调整丙硫氧嘧啶的治疗。我们认为，这种针对特定格雷夫斯病患者的方法可能会改善这些妊娠的结局。
