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分娩第二产程甲状腺危象:1 例报告。

Thyroid storm in the second stage of labour: a case report.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo General Hospital, Jakarta Pusat, Indonesia.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo General Hospital, Jakarta Pusat, Indonesia

出版信息

BMJ Case Rep. 2021 Jul 21;14(7):e243159. doi: 10.1136/bcr-2021-243159.

Abstract

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.

摘要

甲状腺危象(或甲状腺危象)是内分泌学中的急症。它是甲状腺功能亢进症的一种并发症,可能危及生命。妊娠期间甲状腺功能亢进症控制不佳可能发展为甲状腺危象,尤其是在围产期。我们介绍了一位处于第二产程的女性,患有甲状腺危象、子痫前期、急性肺水肿和即将发生的呼吸衰竭。给予甲状腺危象、子痫前期方案和皮质类固醇治疗。婴儿顺利分娩,而母亲在住院 5 天后出院。分娩是妊娠期间未控制的甲状腺功能亢进症发展为甲状腺危象的重要诱因。尽管非常罕见,但它可能会导致严重后果。甲状腺危象的诊断和治疗指南已经存在,应该积极、立即进行。应通过适当控制甲状腺激素水平来预防未控制的甲状腺功能亢进症,尤其是在围产期之前。

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