Hyperthyroidism, referred to as "hyperthyroidism", is a disease caused by excessive hormone hormones. It is particularly good to occur in women of childbearing age and has a very important impact on reproductive health.
Due to the merging during pregnancy or the occurrence of hyperthyroidism, it may cause serious consequences such as miscarriage, premature birth, and deformities, so hyperthyroidism has also attracted more and more attention from obstetrics and gynecology, endocrinology, and reproductive departments.
The author hopes that this article can solve the misunderstandings of hyperthyroidism in pregnancy during pregnancy and treatment, making patients more assured of the twists and turns on the road of pregnancy.
1. What is the performance of hyperthyroidism during pregnancy?
Patients with mild or early pregnancy period can have no symptoms!Therefore, it can only be discovered by going to the hospital for examination.
The clinical manifestations of patients with hyperthyroidism lack specificity, and they are often very similar to the manifestations of other diseases, so they are often missed. For example, patients with hyperthyroidism during pregnancy can be manifested as fear of heat, sweating, and even low heat;Insomnia, irritability, increased heart rate or palpitations, nausea, vomiting, etc.These manifestations are also very similar to the normal early pregnancy of the human body in the early pregnancy, so it is difficult to identify; only a few patients with severe condition may have more food, hunger, increased number of defecation, prominent eyeballs, and even thyroid enlargement.
2. Why is hyperthyroidism during pregnancy?
In early pregnancy, the placenta secretes a large number of human chorionic gonadotropin (HCG). Part of the structure of this hormone molecule is very similar to the periocynum hormone (TSH) and can also play a certain function of promoting the thyroid gland. This is the so -called "HCG hyperthyroidism ".
Therefore, in the early stages of pregnancy, patients with hyperthyroidism may increase their condition, and some pregnant women may even be accompanied by gaming during pregnancy.At this time, as long as the armor is not a serious abnormality, it does not require too much treatment. Observation and review are the best choices.
After the middle of pregnancy, the level of HCG secreted by the placenta is stable, and the body has gradually adapted to the state of higher hormone levels, and a new hormone secretion and regulating balance point is formed. Therefore, the condition of hyperthyroidism will be relieved.
After childbirth, the maternal endocrine environment will change more violently again, and the condition of hyperthyroidism will often increase again. Therefore, the past treatment should continue, and the maternal should go to the hospital as early as 42 days after delivery.
3. What are the harms of hyperthyroidism during pregnancy?
The impact and disease that hyperthyroidism during pregnancy on the mother and pregnancy process includes:
异, even heart failure, thyroid danger, hypertension of unknown causes, etc.;
Patients with hyperthyroidism, the probability of abortion, premature birth, and deformity of the child is also significantly higher than that of ordinary pregnant women;
After the mother’s hyperthyroidism, the possibility of delayed development in the palace, thyroid dysfunction, and thyroid enlargement may also increase, and the probability of being diagnosed with a full moon (weight less than the normal value of the gestational week) after birth after birth) alsoStepping.
Therefore, in strict accordance with the doctor’s order during the early pregnancy, it is best to start a regular check-up at 6-8 weeks. Check the first skills. If there is no abnormalities, continue to observe.
4. How to treat hyperthyroidism during pregnancy?
The main treatment goal of hyperthyroidism during pregnancy is to control the mother’s thyroid function to the normal range and maintain the upper limit of the FT4 in the reference range of normal non -pregnant people.Asian clinical hyperthyroidism does not require treatment.
In the treatment of hyperthyroidism during pregnancy, anti -thyroid drugs are preferred, priority is preferentially selected in the early pregnancy, and propypioline (PTU) is preferred, and hypalidazole (MMI) is preferred during medium and late pregnancy.During pregnancy and lactation, radioactive iodine preparations are disabled.However, all drugs have certain side effects. The incidence of the mother is 10-15%, mainly including: reducing white blood cells, liver damage, allergic reactions, vasculitis, etc.
If a severe systemic side reaction is generated after using anti -thyroid drugs, it is difficult to continue treatment; or the volume of thyroid mysteria continues to increase, and the drug dosage needs to be continuously increased; or patients cannot strictly obey the medicine and review.Then prepare for surgery.In order to maximize the risk of surgery, surgery should be performed in the second trimester.
5. What impact does the drug of hyperthyroidism during pregnancy have on the mother and children?
The use of anthology drugs during pregnancy should pay special attention to the safety and teratogenicity of the fetus.
Drugs were used to be used clinically, but due to certain teratogenicity to the fetus, it is not recommended to use it in the early stages of pregnancy.
Anti -thyroid drugs may pass the placenta, causing abnormality of fetal thyroid development and function, making fetal goiter and low thyroid dysemonia. The greater the dose of the drug, the greater the risk. For exampleTo review liver merit.
In view of the particularity and side effects of hyperthyroidism drugs, women should not be pregnant before hyperthyroidism. The ideal pregnancy time is to ensure that the nailing skills are stable for a period of time after stopping the drug, and it is necessary to ensure that there is no abnormal hormone before going to pregnancy.
In summary, the onset of hyperthyroidism during pregnancy is relatively hidden. Early detection and reasonable treatment can reduce the risk of mothers and children’s bad ending; anti -thyroid drugs have certain side effects.Gong, avoid hypothyroidism caused by excessive treatment.
Author introduction: Han Lei attended physician · obstetrics, Han Lei third military medicine department obstetrics and gynecology science, doctor of medicine, is mainly good at diagnosis and treatment of common diseases and diseases of obstetrics and gynecology, perinatal medical care and prenatal consultation, pregnancy -related diseases during pregnancy, and related diseases during pregnancy.Diagnosis and treatment.
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