Thyroid function in pregnancy
Thyroid function in pregnancy
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DOI：
10.1093/bmb/ldq039
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发表时间：
2011-03-01
影响因子：
6.7
通讯作者：
Lazarus, John H.
中科院分区：
文献类型：
--
作者：
Lazarus, John H.
在了解正常妊娠甲状腺功能的生理学方面的进展突出了功能异常对产科结局和胎儿健康的重要性。使用术语甲状腺和妊娠进行PubMed检索。协议的领域如下：妊娠正常参考范围的甲状腺功能检查需要适当的解释任何异常。甲状腺刺激抗体和抗甲状腺过氧化物酶抗体的测定有助于妊娠期甲状腺疾病的诊断。Graves'甲亢的治疗应仅在妊娠早期使用丙基硫氧嘧啶，然后使用卡比咪唑或甲巯咪唑。服用左旋甲状腺素的患者在妊娠期间需要增加剂量。争议领域如下：妊娠期总甲状腺素（TT4）与游离T4（FT4）测定。妊娠早期甲状腺功能筛查：是否应该对每个人进行常规检查？什么样的测试是合适的？生长点如下：甲状腺素输送到胎儿的生理学。妊娠期甲状腺激素参考范围的建立。妊娠早期甲状腺功能筛查策略的评价。及时开展研究的领域如下：胎盘甲状腺激素生理学、甲状腺激素治疗和甲状腺功能筛查。
Advances in understanding the physiology of thyroid function in normal pregnancy have highlighted the importance of the consequences of abnormal function on obstetric outcome and foetal well-being. Pubmed search was done using the terms thyroid and pregnancy. Areas of agreement are the following: gestational normative reference ranges for thyroid function tests are required for proper interpretation of any abnormalities. Measurement of thyroid-stimulating antibodies and antithyroid peroxidase antibodies is useful for diagnosis of thyroid disease in pregnancy. Treatment of Graves' hyperthyroidism should be done with propylthiouracil for first trimester only, then carbimazole or methimazole. Patients on levothyroxine require an increase in dosage during gestation. Areas of controversy are the following: total thyroxine (TT4) versus Free T4 (FT4) assays in pregnancy. Screening for thyroid function in early gestation: should it be routinely performed on everyone? What tests are appropriate? Growing points are the following: physiology of thyroxine delivery to the foetus. Establishment of gestational thyroid hormone reference ranges. Evaluation of strategies to screen thyroid function in early pregnancy. Areas timely for developing research are the following: placental thyroid hormone physiology, thyroid hormone therapy and screening thyroid function.