摘要
目的探讨妊娠合并甲状腺功能亢进症(甲亢)的母儿结局和处理原则。方法回顾性分析41例妊娠合并甲亢患者的临床资料,将其分为病情控制组和病情未控制组,将病情控制组再次分为需服药组和无需服药组,病情未控制组再次分为甲亢孕前诊断组和甲亢孕期首次诊断组,对各组间的妊娠并发症、妊娠结局和围生儿结局进行对照研究。结果病情未控制组子痫前期重度、充血性心力衰竭、早产、产后出血、低出生体质量儿发生率分别为66.6%、46.6%、53.3%、33.3%、33.3%,明显高于病情控制组的19.2%、0%、11.5%、11.5%、3.8%,子痫前期重度在病情未控制组的并发症中起中心作用。病情未控制组中甲亢孕期首次诊断组的充血性心力衰竭、产后出血、早产、剖宫产发生率均为4/4,明显高于甲亢孕前诊断组的27%、9%、36.3%、36.3%。结论妊娠合并甲亢,甲亢病情控制者母儿结局良好;病情未控制者母儿并发症发生率明显增高,尤以甲亢孕期首次诊断者预后最差;孕前或孕期尽早发现并控制甲亢病情相当重要。
Objective To investigate the clinical outcome and management of pregnancy complicated with hyperthyroidism.Methods Clinical data of 41 cases of pregnancy with hyperthyroidism from Jan.,2002 to Dec.,2008 in our hospital were retrospectively analyzed.Patients were divided into two groups as the disease-controlled group and the disease-uncontrolled group.The disease-controlled group was subdivided into two groups as drug-treated subgroup and drug-untreated subgroup.The disease-uncontrolled group was also subdivided into two groups as hyperthyroidism diagnosed pre-pregnancy subgroup and hyperthyroidism firstly diagnosed during-pregnancy subgroup.Maternal complications,pregnancy outcome and perinatal infant outcome were comparably studied among these groups.Results The incidence of severe preeclampsia,congestive heart failure,premature delivery,postpartum hemorrhage,low-body-weight newborn in the disease-uncontrolled group was 66.6%,46.6%,53.3%,33.3% and 33.3%,respectively,which was higher than the incidence of those in the disease-controlled group,that was 19.2%,0%,11.5%,11.5% and 3.8%,respectively.Severe preeclampsia played the central role in the complications of the disease-uncontrolled group.The incidence of congestive heart failure,postpartum hemorrhage,premature delivery,uterine-incision delivery in the hyperthyroidism firstly diagnosed during-pregnancy subgroup of disease-uncontrolled group was all 4/4,which was markedly higher than the incidence of those in the hyperthyroidism diagnosed pre-pregnancy subgroup,that was 27%,9%,36.3% and 36.3%,respectively.Conclusion The clinical outcome of pregnancy with hyperthyroidism is well as hyperthyroidism is well-controlled,while the complication incidence is markedly higher as hyperthyroidism is uncontrolled.Moreover,the clinical outcome is the worst as hyperthyroidism is firstly diagnosed during-pregnancy.Thus,finding and controlling hyperthyroidism pre-and during pregnancy is very important.
出处
《安徽医学》
2009年第12期1438-1441,共4页
Anhui Medical Journal
