Iwen K A, Lehnert H
Universitäres MVZ Lübeck, Universitätsklinikum Schleswig-Holstein, Königstr. 101-105, 23552, Lübeck, Deutschland.
Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland.
Internist (Berl). 2018 Jul;59(7):654-660. doi: 10.1007/s00108-018-0435-0.
During pregnancy thyroid hormones have profound effects on embryonal/fetal development and maternal health. Therefore, thyroid gland disorders should be immediately diagnosed and adequately treated. Pregnancy-specific physiological alterations during pregnancy cause changes in the reference interval for thyroid-stimulating hormone levels and trimester-specific thresholds must be taken into account. This article summarizes the most important diagnostic and therapeutic aspects before, during and after pregnancy. With reference to the period prior to pregnancy, the article discusses iodide supplementation, preconceptional examination of thyroid gland metabolism and the importance of thyroid gland functional disorders for fertility and fulfilling the desire to have children. With a view to the period during pregnancy, the effect of hypothyroxinemia, hypothyroidism, and hyperthyroidism as well as the effects of their treatment on the development of the child are explained. Finally, a description is given of what must be paid attention to in the breast-feeding period and in postpartum thyroiditis.
孕期甲状腺激素对胚胎/胎儿发育及母体健康有深远影响。因此,甲状腺疾病应立即诊断并得到充分治疗。孕期特定的生理改变会导致促甲状腺激素水平参考区间发生变化,必须考虑各孕期的特定阈值。本文总结了妊娠前、妊娠期间及产后最重要的诊断和治疗方面。关于妊娠前阶段,本文讨论了碘补充、甲状腺代谢的孕前检查以及甲状腺功能障碍对生育和实现生育愿望的重要性。着眼于孕期,解释了低甲状腺素血症、甲状腺功能减退和甲状腺功能亢进的影响以及它们的治疗对胎儿发育的影响。最后,描述了哺乳期和产后甲状腺炎需要注意的事项。