Swaminathan Srinivasan, James Roshin Ann, Chandran Rashmi, Joshi Reesha
Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Anesth Essays Res. 2017 Oct-Dec;11(4):1115-1117. doi: 10.4103/aer.AER_38_17.
Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole. Anesthetic management of these cases is challenging in view of the emergency nature of the surgery and potential for thyroid crisis. Spinal anesthesia can be safely administered and has a protective role in preventing thyroid crisis.
患有妊娠滋养细胞疾病的孕妇因人类绒毛膜促性腺激素分泌增加而继发甲状腺功能亢进的可能性增加。这些甲状腺功能亢进病例大多未被诊断出来，可能在围手术期表现为甲状腺危象。患有妊娠滋养细胞疾病的孕妇应始终接受甲状腺功能亢进评估，对于严重甲状腺功能亢进的病例，应在清宫术前开始抗甲状腺治疗。鉴于手术的紧急性质和甲状腺危象的可能性，这些病例的麻醉管理具有挑战性。脊髓麻醉可以安全实施，并且在预防甲状腺危象方面具有保护作用。
