Glinoer D
CHU Saint Piere, Département de Médecine Interne (Endocrinologie), Bruxelles, Belgique.
Ann Endocrinol (Paris). 1997;58(3):263-7.
Most thyroid nodules discovered during pregnancy are benign. In this article, we propose a pragmatic attitude for the diagnosis and treatment of such nodules, insisting particularly on the importance of thyroid echography and fine needle aspiration. For women who have successfully been treated for thyroid cancer before pregnancy, we discuss the adaptation of thyroxine substitution when they become pregnant, the obstetrical and fetal risks (spontaneous miscarriage, fetal abnormalities of the thyroid gland and others), and also potential later risks for the child, in relation with previous radioactive iodine administration to the mother. Finally, we evoke more difficult questions, such as the rare instances in which thyroid cancer is discovered during pregnancy, pregnancy occurring during the months immediately following radioiodine treatment, and exceptional cases where therapeutic radioiodine was inadvertently given during pregnancy.
孕期发现的大多数甲状腺结节是良性的。在本文中,我们针对此类结节的诊断和治疗提出一种务实的态度,特别强调甲状腺超声检查和细针穿刺活检的重要性。对于孕前已成功治疗甲状腺癌的女性,我们讨论她们怀孕时甲状腺素替代治疗的调整、产科和胎儿风险(自然流产、胎儿甲状腺异常等),以及与母亲先前接受放射性碘治疗相关的孩子日后潜在风险。最后,我们引出一些更棘手的问题,比如孕期发现甲状腺癌的罕见情况、放射性碘治疗后紧接着几个月内怀孕的情况,以及孕期意外给予治疗性放射性碘的特殊病例。