妊娠合并甲状腺功能亢进26例临床分析

目的:探讨妊娠合并甲状腺功能亢进的临床特点及处理原则。方法:回顾性分析我院11年间妊娠合并甲状腺功能亢进26例患者的资料,按照正规治疗与否分为对照组17例和治疗组9例。结果:①两组患者甲状腺激素水平差异有显著性(P<0.01)。②妊娠结局:治疗组新生儿平均体重、1分钟Apgar评分与对照组比较,差异有显著性(P<0.05)。③分娩方式:治疗组患者阴道分娩4例,剖宫产4例;对照组患者经阴道产钳助娩1例,剖宫产9例。④并发症:对照组中5例患者合并妊娠期高血压疾病(其中子痫前期4例),4例患者合并心功能不全,2例患者发生甲状腺危象。治疗组中1例患者同时合并子痫前期。结论:①孕期病情控制的患者可视同正常妊娠;②中、重度妊娠合并甲状腺功能亢进症适当放宽剖宫产指征;③产时及产后防止心功能不全和甲状腺危象。

Clinical Analysis of Hyperthyroidism in Pregnancy:Report of Twenty-six Cases

Objective:To evaluate the management and treatment of hyperthyroidism in pregnancy.Methods:We reviewed medical records of twenty-six cases with hyperthyroidism during pregnancy at our hospital over a period of 11 years.26 cases were divided into two groups according to their therapy records,one group has 9 cases with standard treatment,the other has 17 cases without standard treatment as control.Results:1.Compared with standard therapy group,the serum levels of FT4/ FT3 in non-standard therapy group were significantly higher and the serum levels of TSH were significantly lower(P<0.01).2.Pregnant Outcome:The mean newborn weight and one minute Apgar score after delivery of ten cases in control group were significantly lower than that of the standard therapy group(P<0.05).3.Delivery way:In the control group,1 case was delivered with forceps,9 cases were delivered by caesarean-section.In the standard therapy group,4 cases delivered through vagina,4 cases were delivered by caesarean-section.3.Complications: In the control group,5 cases were complicated with pregnancy-induced hypertension(4 cases pre-eclampsia).4 cases with cardiac failure,2 cases with thyrointoxication.In the standard treatment group,only 1 case was complicated with pre-eclampsia.Conclusions:1.Mild hyperthyroidism patients during pregnancy should be managed as normal if treated properly and promptly.2.It is suggested that caesarean-section may be a good choice in pregnancies with middle and severe hyperthyroidism.3.Heart failure and thyrointoxication must be prevented in labor and after delivery.