Thomas-Desrousseaux P
Clinique Universitaire de Gynécologie-Obstétrique et Pathologie de la Reproduction, Pavillon Paul-Gellé, Roubaix.
Rev Fr Gynecol Obstet. 1989 Dec;84(12):928-31.
Post-partum dysthyroidism are not well understood by obstetricians, but are rather frequent (5.5% of the cases); they usually are the manifestation of a lympho-plasmocytic thyroidism with auto-immune origin. They are encouraged by a genetic predisposition and sometimes by food with a high iodine content. The disease starts with a phase of early thyreotoxicosis, 1 to 3 months following delivery, then later with hypothyroidism (from the 3rd to the 9th month), associated with menstrual disorders, an amenorrhea-galactorrhea syndrome or still, the occurrence of a goiter. Most of the time, the course is favorable, even in the absence of treatment with spontaneous return to euthyroidism within a few months, although the chance of permanent hypothyroidism is however non negligible. The diagnosis is difficult, and the treatment should be the least aggressive possible: beta-blocker during the thyreo-toxicosis phase, supplemental treatment during the hypothyroidism phase. There is a risk of recurrence during subsequent pregnancies.
产科医生对产后甲状腺功能障碍了解不足，但这种情况相当常见（占病例的5.5%）；它们通常是自身免疫性起源的淋巴细胞-浆细胞性甲状腺炎的表现。遗传易感性有时还有高碘含量的食物会促发该病。该病始于产后1至3个月的早期甲状腺毒症阶段，随后在3至9个月出现甲状腺功能减退，伴有月经紊乱、闭经-溢乳综合征，或者还会出现甲状腺肿。大多数情况下，病情发展良好，即使不进行治疗，几个月内也会自发恢复到甲状腺功能正常状态，不过永久性甲状腺功能减退的可能性也不可忽视。诊断困难，治疗应尽可能采取温和方式：甲状腺毒症阶段使用β受体阻滞剂，甲状腺功能减退阶段进行补充治疗。后续妊娠时有复发风险。
