Sullivan Scott A
Department of Obstetrics/Gynecology, Division of Maternal-Fetal Medicine, Medical University of South Carolina, Charleston, South Carolina.
Clin Obstet Gynecol. 2019 Jun;62(2):308-319. doi: 10.1097/GRF.0000000000000432.
Hypothyroidism in pregnancy is defined as the presence of an elevated thyroid stimulating hormone during gestation, affecting 2% to 3% of the population. Overt hypothyroidism is diagnosed by a decreased FT4, while patients with a normal FT4 are considered to have subclinical disease. Poorly controlled disease is associated with both pregnancy complications and developmental delays in the offspring. Treatment consists of replacement with levothyroxine and regular monitoring. Most pregnant women will require an increase in their dosing from 25% to 30%. While treatment for SCH remains controversial, current recommendations do not support universal screening of low-risk women during pregnancy.
妊娠期甲状腺功能减退症定义为妊娠期间促甲状腺激素升高，影响2%至3%的人群。临床显性甲状腺功能减退症通过游离甲状腺素（FT4）降低来诊断，而FT4正常的患者被认为患有亚临床疾病。疾病控制不佳与妊娠并发症及后代发育迟缓均有关联。治疗方法为服用左甲状腺素进行替代治疗并定期监测。大多数孕妇需要将剂量增加25%至30%。虽然亚临床甲状腺功能减退症（SCH）的治疗仍存在争议，但目前的建议不支持对低风险孕妇进行普遍筛查。
