Hypertrophy of thyroidism, referred to as "hyperthyroidism", is a disease caused by excessive secretion of thyroid hormones. It is particularly good to occur in women of childbearing age.Because the combined hyperthyroidism during pregnancy may cause serious consequences such as abortion, premature birth, and malformations, it is important to understand the combined hyperthyroidism during pregnancy and protect the protection!
The thyroid gland is one of the most important endocrine organs of the human body. The thyroid hormone plays an important role in reproductive, growth and development, and metabolic regulation of various organs.Hyperthyroidism is more common in female patients, and the ratio of men and women is 1: 4 to 6, of which women aged 20 to 40 years old are more common.Among the endocrine diseases of women in pregnancy, thyroid diseases are second only to the second place in diabetes.
Most of the hyperthyroidism during pregnancy is Graves (toxic permeable thyroidistness) disease. This is a disease that is mainly caused by autoimmune and mental stimulation, characterized by diffuse thyroid glandular and anommistic symptoms.Data show that the incidence of hyperthyroidism and pregnancy is 0.5%to 2%.The abortion rate of hyperthyroidism is as high as 26%and the premature birth rate is 15%.
Causes of hyperthyroidism during pregnancy
The etiology of hyperthyroidism during pregnancy is basically the same as the cause of hyperthyroidism during non -pregnancy, of which the is most common in GravesFollowed by toxic nodular thyroid, thyroid autonomous high -function adenoma.In addition, hyperthyroidism can occur in pregnancy drama spitting, hydatidal, malignant hydatidal and choric membrane epithelial cancer.
Pathological hyperthyroidism during pregnancy is extremely rare, and the incidence is extremely low. Even if there is hyperthyroidism before pregnancy, it is often relieved or reduced due to reduced immune activity after pregnancy.
Therefore, most pregnancy and hyperthyroidism are hyperthyroidism. The reason for the onset is that the estrogen level after pregnancy is increased, which stimulates the increase of the nailing gonadine binding protein in the liver, which makes serum thyroxine (T4) and triaxyxyl glands.The levels of pH (T3) have increased.In addition, the stimulation of chorionic gonad hormones can also increase the level of serotonine.
Why isn’t hyperthyroidism during pregnancy?
Patients with minor or early pregnancy period can have no symptoms! Therefore, only go to the hospital for examination can be found.
Of course, hyperthyroidism can slowly cause or occur suddenly, and the condition can be mild or severe.Passing and tachycardia, for persistent tachycardia, that is, there are small panic and tachycardia at the day and night, and the treatment of general treatment cannot be improved.Afraid of heat, sweating, and at different temperature conditions than others, sweaty, often moist skin.Hypical appetite, good appetite, and obvious amount of meals than ordinary people.
Given that some of the symptoms of women in pregnancy are similar to the manifestations of hyperthyroidism, they have some difficulty to the diagnosis of hyperthyroidism during pregnancy.For women with normal pregnancy, due to the hypertrophy of the pituitary gland, thyroid enlargement may occur. Due to the increased level of estrogen in the blood, the thyroid binding globulin (TBG) increased, because the total serum T3 and total T4 also increased accordingly. In additionDuring pregnancy, fears, sweating, even low fever, or weakness.
These are very similar to the performance of hyperthyroidism. Due to these changes, it is difficult to identify the clinical change of hyperthyroidism as a normal pregnancy.Only a few patients with severe condition may have food, hunger, increased number of defecation, prominent eyeballs, and even thyroid mysteria.
During pregnancy, only a small amount of serum thyroxine (T4) and tritenonopine (T3) can be used through the placenta due to the placenta barrier, so it does not cause neonatal hyperthyroidism.Pregnancy has little effect on hyperthyroidism. On the contrary, the condition of hyperthyroidism can often be relieved to varying degrees of hyperthyroidism.
Hyperthyroidism during pregnancy can lead to abortion, premature birth, death, etc.
However, the severe hyperthyroidism of pregnancy, because pregnancy can aggravate the burden on the heart, increased the original heart disease of patients with hyperthyroidism.Individual patients can induce hyperthyroidism due to childbirth, postpartum bleeding, and infection.
Because hyperthyroidism during pregnancy has potential harm to both pregnant women and fetuses, it can cause abortion of pregnant women, thyroid hazardity, signsonia, heart failure, and premature placental peeling.It can also cause stagnation, premature babies, dead tires, congenital malformations, etc. in the fetal palace.
How to prevent it?
1. It is recommended to screen thyroid function before and early pregnancy (4-6 weeks), especially those with a family history of thyroid disease.
2. Do not exclude ATD treatment during pregnancy during pregnancy. The drug concentration of ATD in milk is 10%of the serum drug concentration during the same period.Compared with PTU, MMI’s high milk discharge rate is rarely combined with serum protein. The first choice of PTU on hyperthyroidism during lactation.
The use of PTU 300 mg/day or MMI20 mg/day during breastfeeding has no significant effect on fetal thyroid dysfunction, but it is still necessary to monitor infant armor.Mother took ATD during breastfeeding, and no complications such as decreased granulocytes and liver damage were found in future generations.It is recommended that the mother should take ATD after breastfeeding, and then take the next breastfeeding for 3-4 hours.
3. It is recommended that pregnancy hypertension, especially pregnant women in the early stage of severe eclampity to do armor -action examination.
4. The clinical manifestation of hyperthyroidism during pregnancy is that the symptoms of hyperthyroidism in the first five months of pregnancy increase the symptoms of hyperthyroidism.Newborn hyperthyroidism is related to the mother’s thyroid itself.
TSH receptor antibodies (TRAB) can pass through the placenta. Trab includes TSH receptor stimulation antibodies (TSAB) and TSH receptor blocking antibodies (TSBAB).The former causes fetal hyperthyroidism; the latter causes hypothyroidism.
5. Live birth and childbirth.Hyperthyroidism is prone to premature birth, and auctional premature birth should be actively protected.Infection, mental stimulation, and emotional fluctuations should be avoided during pregnancy.At 36 weeks, you can be admitted to the hospital in advance to closely monitor pregnant women and fetuses.
Hypertrophic mothers generally have strong contractions, small fetal fetuses, and relatively short labor. They should supplement sufficient energy during the output process and encourage eating.If the production process is not smooth, the fetal position is incorrect, the fetal goiter is large, which causes the fetal head to stretch back, and the fetal head cannot enter the basin. The cesarean section should be relaxed.
Antibiotic prevention infection was applied after delivery.When the newborn is born, the pediatrician should be present to prepare for the recovery of the newborn; prepare umbilical cord blood for thyroid function series.Neonatal hyperthyroidism is sometimes delayed (normal newborn thyroid function returns to normal adult level 1 week after birth). Therefore, it is recommended to extend the hospitalization day to observe appropriately.
The postpartum condition of hyperthyroidism may increase, and it will be relieved after about a few months.Therefore, the ATD dose should be reviewed before discharge of hyperthyroidism.
Review: Health Popularization Branch
This article is created by KK Healthy Original, which is first published in Healthy China APP. Please contact us for reprinting
For more wonderful articles, please search for KK health or download health China APP
KK healthy, professional medical comics, medical animation, visualized production service providers.