Management of fetal endocrine disorders
Management of fetal endocrine disorders
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DOI：
10.1016/s1096-6374(03)00056-x
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发表时间：
2003-08-01
影响因子：
1.4
通讯作者：
Hughes, IA
中科院分区：
文献类型：
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作者：
Hughes, IA
一些母体内分泌失调，如果在怀孕期间活跃，可能对新生儿产生不利影响。通常，这些影响是可以预期的，如在格雷夫斯病，或不良反应可以预防，如在巨大儿的婴儿的糖尿病母亲。有时，有机会对胎儿内分泌失调进行产前治疗。例如，在分娩过程中可能引起问题的大甲状腺肿可以通过子宫内给予甲状腺激素或作为穿过胎盘的类似物来治疗。预防重大出生缺陷的一种独特有效的治疗形式是向母亲施用地塞米松，以避免患有先天性肾上腺增生症（CAH）的女性胎儿男性化。然而，这种治疗只能在临床试验的框架内进行，因为子宫内暴露于强效糖皮质激素的长期影响尚不清楚。影响约5%新生儿的宫内生长迟缓目前不适合在出生前直接进行药物治疗。然而，有更实际的选择来管理这种情况，包括改善产妇营养和避免对胎儿生长有害的毒素。(C)2003爱思唯尔科技有限公司版权所有。
A number of maternal endocrine disorders, when active during pregnancy, can have adverse effects on the newborn. Frequently, these affects can be anticipated as in Graves' disease, or the adverse effect can be prevented as in macrosomia in the infant of the diabetic mother. Occasionally, there are opportunities for prenatal treatment of a fetal endocrine disorder. For instance, a large goitre that may cause problems during delivery can be treated with thyroid hormones administered intra-amniotically or as analogues that cross the placenta. A uniquely effective form of treatment for prevention of a major birth defect is administration of dexamethasone to the mother to avoid virilisation of a female fetus with congenital adrenal hyperplasia (CAH). However, such treatment should only be conducted within the framework of a clinical trial as the long-term effects of exposure to potent gluco-corticoids in utero are unknown. Intrauterine growth retardation, which affects about 5% of newborns, is currently not amenable to direct pharmacological treatment before birth. However, there are more practical options for managing this condition, including improved maternal nutrition and avoidance of toxins injurious to fetal growth. (C) 2003 Elsevier Science Ltd. All rights reserved.