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孕期甲状腺功能亢进症的管理:一项系统文献综述。

Management of Hyperthyroidism during Pregnancy: A Systematic Literature Review.

作者信息

Petca Aida, Dimcea Daiana Anne-Marie, Dumitrașcu Mihai Cristian, Șandru Florica, Mehedințu Claudia, Petca Răzvan-Cosmin

机构信息

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Department of Obstetrics and Gynecology, Elias University Hospital, 011461 Bucharest, Romania.

出版信息

J Clin Med. 2023 Feb 24;12(5):1811. doi: 10.3390/jcm12051811.

Abstract

In pregnancy, several physiological changes affect maternal circulating thyroid hormone levels. The most common causes of hyperthyroidism in pregnancy are Graves' disease and hCG-mediated hyperthyroidism. Therefore, evaluating and managing thyroid dysfunction in women during pregnancy should ensure favorable maternal and fetal outcomes. Currently, there is no consensus regarding an optimal method to treat hyperthyroidism in pregnancy. The term "hyperthyroidism in pregnancy" was searched in the PubMed and Google Scholar databases to identify relevant articles published between 1 January 2010 and 31 December 2021. All of the resulting abstracts that met the inclusion period were evaluated. Antithyroid drugs are the main therapeutic form administered in pregnant women. Treatment initiation aims to achieve a subclinical hyperthyroidism state, and a multidisciplinary approach can facilitate this process. Other treatment options, such as radioactive iodine therapy, are contraindicated during pregnancy, and thyroidectomy should be limited to severe non-responsive thyroid dysfunction pregnant patients. In light of this events, even in the absence of guidelines certifying screening, it is recommended that all pregnant and childbearing women should be screened for thyroid conditions.

摘要

在孕期,多种生理变化会影响母体循环甲状腺激素水平。孕期甲状腺功能亢进最常见的病因是格雷夫斯病和人绒毛膜促性腺激素介导的甲状腺功能亢进。因此,评估和管理孕期女性的甲状腺功能障碍应确保母婴获得良好结局。目前,对于孕期甲状腺功能亢进的最佳治疗方法尚无共识。在PubMed和谷歌学术数据库中检索了“孕期甲状腺功能亢进”一词,以识别2010年1月1日至2021年12月31日期间发表的相关文章。对所有符合纳入时间段的所得摘要进行了评估。抗甲状腺药物是治疗孕妇的主要方式。开始治疗旨在达到亚临床甲状腺功能亢进状态,多学科方法有助于这一过程。其他治疗选择,如放射性碘治疗,在孕期是禁忌的,甲状腺切除术应仅限于严重难治性甲状腺功能障碍的孕妇患者。鉴于此,即使没有认证筛查的指南,也建议对所有孕妇和育龄妇女进行甲状腺疾病筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f94b/10003540/a8f5822f71eb/jcm-12-01811-g001.jpg

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