Abstract: Pregnancy complicated by hyperthyroidism should be taken seriously because this disease may affect two generations. Hyperthyroidism, also known as hyperthyroidism, is a common endocrine disease. Pregnancy complicated by hyperthyroidism can cause many adverse effects on pregnant women and their offspring. If symptoms such as heat sensitivity, excessive sweating, nausea and vomiting, or a fast heart rate (heart rate 100 beats/min) occur after pregnancy, you should pay attention.
Han Yajuan, deputy director of the Department of Endocrinology and Metabolism at the Hospital of Integrated Traditional Chinese and Western Medicine at Southern Medical University, said: Pregnancy complicated by hyperthyroidism should be taken seriously because this disease may affect two generations. Hyperthyroidism, also known as hyperthyroidism, is a common endocrine disease. In 2013, survey data from the Endocrinology Branch of the Chinese Medical Association showed that the incidence rate of hyperthyroidism in my country was 3.7%, with an average of 1 hyperthyroidism patient for every 27 people. Pregnancy complicated by hyperthyroidism is not uncommon, with an incidence rate of 0.5-2%. Among them, pregnancy complicated by Graves\’ disease (the cause of hyperthyroidism includes diffuse toxic goiter, referred to as GD) is the most common.
There are many causes of hyperthyroidism. Pay attention to these two during pregnancy
The causes of hyperthyroidism are diverse, including diffuse toxic goiter (Graves\’ disease), inflammatory hyperthyroidism (subacute thyroiditis, etc.), drug-induced hyperthyroidism, hCG-related hyperthyroidism (transient hyperthyroidism caused by vomiting during pregnancy), pituitary gland Hyperthyroidism, etc. TSH tumor hyperthyroidism.
Han Yajuan introduced that hyperthyroidism in pregnancy is mainly caused by transient thyrotoxicosis (GTT) and Graves\’ disease in pregnancy. The former is related to elevated hCG concentration and does not require treatment; the latter is related to thyroid autoimmune abnormalities and is the most common form of hyperthyroidism in early pregnancy. s reason. The clinical manifestations are that symptoms worsen in the first 5 months of pregnancy and decrease in the last 5 months. Because the cause is autoimmune, thyrotropin receptor antibody (TRAb) testing is required.
Many changes during pregnancy are similar to the clinical manifestations of hyperthyroidism, making diagnosis difficult. Han Yajuan reminded that if you experience heat sensitivity, sweating, nausea and vomiting, or rapid heartbeat (heart rate 100 beats per minute), or your weight does not increase with the number of months of pregnancy, or even the proximal limbs become thinner, you should seek medical attention immediately to rule out hyperthyroidism.
What should pregnant mothers do if they have hyperthyroidism?
Han Yajuan pointed out that untreated or poorly controlled hyperthyroidism may have adverse effects on pregnant women and fetuses. Effects on the pregnant woman include stillbirth, premature birth, preeclampsia, congestive heart failure, hyperthyroid crisis, miscarriage, placental abruption, infection, and effects on the fetus include neonatal hyperthyroidism, intrauterine growth retardation, prematurity, term Small Sample of Children (SGA). In addition, hyperthyroidism during pregnancy can also lead to various types of thyroid dysfunction in fetuses and newborns, including fetal and neonatal hyperthyroidism and hypothyroidism.
Medications or surgeries vary from person to person
Expectant mothers can undergo drug treatment and surgical treatment as needed, but radioactive iodine 131 treatment is contraindicated. Han Yajuan emphasized.
The goal of treating hyperthyroidism in pregnancy is to reduce thyroid hormone levels. Antithyroid drugs are the first choice for treatment to control symptoms and restore normal thyroid function in the smallest possible dose. When patients rely on the minimum dose of ATD (PTU 50 mg/d or MMI 5 mg/d) to maintain normal thyroid function for several weeks, discontinuation of the drug may be considered. Patients who are allergic to anti-drugs, ineffective against anti-drugs, have a heavy psychological burden, and are excessively worried about the side effects of drugs can choose surgical treatment after evaluation by a doctor. Surgical treatment should be more appropriate in the second trimester (4-6 months) to minimize the risk of miscarriage and premature birth. Text/Jinyang.com reporter Chen Yingping, correspondent Wu Jiayi