Yang Ruiqi, Zhu He, Zhang Jialing, Wang Fei, Fan Limei
Department of Obstetrics & Gynecology, Second Hospital, Jilin University, Changchun 130041, China.
Department of Obstetrics & Gynecology, Second Hospital, Jilin University, Changchun 130041, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Sep 23;94(35):2760-2.
To explore the value of prenatal ultrasound in assessing thyroid function in fetuses of hyperthyroidism pregnant women and establish the reference values of fetal thyroid transverse diameter and anteroposterior diameter for different gestational weeks.
For observation group, 30 cases of pregnant women diagnosed as hyperthyroidism were recruited from our hospital from November 2012 to November 2013. And another 100 cases of pregnant women during 20 to 40 weeks of gestational weeks were selected into control group. The measured ultrasonic parameters included fetal biparietal diameter, head circumference, abdominal circumference, femur length, amniotic fluid index, heart rate, fetal thyroid transverse diameter, anteroposterior diameter and fetal movement frequency. A fetus was considered as suspected positive when they were less than gestational age, thyroid measurement higher than 95% confidence interval, heart rate over 160 beats/min or less than 120 beats/min. In the observation group, the blood levels of thyroid stimulating hormone and thyroxine were measured after birth.
The regression equation of fetal thymus transverse diameter and GA was: Y = 0.053X - 0.096, R² = 0.758, P < 0.05; the regression equation of fetal thymus anteroposterior diameter and GA: Y = 0.034X - 0.397, R² = 0.596, P < 0.05. The measured value of 95% confidence interval for 2 cases in observation group exceeded that in control group. There were fetal tachycardia (n = 2), bradycardia (n = 1), low TSH after birth (n = 2), T4 elevation after birth (n = 1) and clinical T4 high value (n = 1).
Ultrasonic assessment of fetal thyroid function is timely and noninvasive. And it has an irreplaceable value in hyperthyroidism pregnant women. And normal reference values of fetal thyroid measurements are established for 20-40 gestation weeks.
探讨产前超声评估甲亢孕妇胎儿甲状腺功能的价值，并建立不同孕周胎儿甲状腺横径和前后径的参考值。
观察组选取2012年11月至2013年11月我院确诊为甲亢的孕妇30例。对照组选取孕周20至40周的孕妇100例。测量的超声参数包括胎儿双顶径、头围、腹围、股骨长、羊水指数、心率、胎儿甲状腺横径、前后径及胎动频率。当胎儿小于孕周、甲状腺测量值高于95%可信区间、心率超过160次/分或低于120次/分，视为疑似阳性。观察组出生后测定促甲状腺激素和甲状腺素血水平。
胎儿甲状腺横径与孕周的回归方程为：Y = 0.053X - 0.096，R² = 0.758，P < 0.05；胎儿甲状腺前后径与孕周的回归方程为：Y = 0.034X - 0.397，R² = 0.596，P < 0.05。观察组2例95%可信区间测量值超过对照组。有胎儿心动过速（n = 2）、心动过缓（n = 1）、出生后促甲状腺激素降低（n = 2）、出生后甲状腺素升高（n = 1）及临床甲状腺素高值（n = 1）。
超声评估胎儿甲状腺功能及时且无创。在甲亢孕妇中具有不可替代的价值。并建立了20 - 40孕周胎儿甲状腺测量的正常参考值。
