Lane Andrew S, Tarvade Sanjay
Critical Care, Sydney Medical School, Penrith, NSW, Australia.
Intensive Care Medicine, Nepean Hospital, Sydney, NSW, Australia.
J Intensive Care Soc. 2015 Aug;16(3):247-252. doi: 10.1177/1751143714559910. Epub 2014 Dec 9.
Thyroid storm is a rare and serious complication of pregnancy which can lead to spontaneous abortion, preterm delivery, preeclampsia and cardiac failure. It is also associated with high maternal and foetal mortality if not diagnosed and managed promptly. The diagnosis of thyroid storm in pregnancy can pose significant challenges due to its presentation being similar to other pregnancy-related complications. We present a patient who developed thyroid storm at 29 weeks of pregnancy, which resulted in pre-term delivery, cardiac failure and thyroidectomy. We discuss the treatment of thyroid storm in pregnancy, the decision making involved in proceeding to thyroidectomy or to use radio-iodine, and foetal thyroid status in thyrotoxicosis.
甲状腺危象是妊娠罕见且严重的并发症，可导致自然流产、早产、子痫前期和心力衰竭。若不及时诊断和处理，还会导致母婴高死亡率。由于甲状腺危象的表现与其他妊娠相关并发症相似，妊娠合并甲状腺危象的诊断极具挑战性。我们报告一例患者，在妊娠29周时发生甲状腺危象，导致早产、心力衰竭并接受了甲状腺切除术。我们讨论了妊娠合并甲状腺危象的治疗、甲状腺切除术或放射性碘治疗的决策以及甲状腺毒症时胎儿的甲状腺状况。
