甲亢突眼最好的医院hyperthyroid

    Pregnancy combined with hyperthyroidism[ summary ] hyperthyroidism ( Graves ) is a common endocrine disease, is caused by excessive secretion of thyroid hormone. Hyperthyroidism in women is often shown as menstrual disorders, reduce or amenorrhea, low fertility. But in the treated or untreated hyperthyroidism in pregnant women, but also many, its incidence is about 1∶ 1000～ 2500 trimester of pregnancy. 甲状腺Hyperthyroidism in pregnancy most is Graves disease, which is a mainly consists of autoimmunity and mental stimulation causes, features of diffuse goiter and exophthalmos. [ ] in normal pregnancy with clinical manifestations of maternal thyroid morphological and functional changes, is similar in many ways to hyperthyroidism clinical manifestations, such as heartbeat tachycardia, increased cardiac output, enlargement of the thyroid gland, skin warmth, hyperhidrosis, fear the heat, bulimia, in pregnancy and hyperthyroidism are common. Mild hyperthyroidism in pregnancy had no significant effect, but in severe hyperthyroidism, and the symptoms did not control the abortion rate, incidence of 杭州市同济医院开的要能退吗 PIH, the preterm birth rate, incidence of small for gestational age infants and perinatal mortality increased.

      Effects of hyperthyroidism on pregnancy is unclear, possibly due to the excessive consumption of nutrients in hyperthyroidism, and pregnancy-induced hypertension incidence is high, and the effects of placental function. Pregnancy with placental barrier, only a small amount of T3, T4 can pass through the placenta, thus causing neonatal hyperthyroidism. Gestational hyperthyroidism had little effect, instead of pregnancy often cause hyperthyroidism have varying degrees of ease. But the pregnancy complicated with severe hyperthyroidism, because of pregnancy may increase the burden on the heart, and increased the original heart lesions in patients with hyperthyroidism. Individual patients due 杭州市同济医院内分泌科to childbirth, postpartum bleeding, infection can be induced hyperthyroidism crisis. [ ] normal pregnancy diagnosis result of maternal thyroid morphological and functional changes, is similar in many ways to hyperthyroidism clinical manifestations, such as heartbeat tachycardia, increased cardiac output, enlargement of the thyroid gland, skin warmth, hyperhidrosis, fear the heat, bulimia, in pregnancy and hyperthyroidism are common, so that pregnancy combined with hyperthyroidism diagnosis some difficulties. In the prenatal examination found that the signs and symptoms of thyrotoxicosis, should be further done to confirm the diagnosis of thyroid function determination. Hyperthyroidism in pregnancy diagnostic criteria for metabolic syndrome: a tall, serum total thyroxine ( TT4 )≥ 180.6nmol/L ( 14 μ g/dl ), total three triiodothyronine ( TT3 )≥ 3.54nmol/L ( 230ng/dl ), free thyroxine index ( FT4I )≥ 12.8. Hyperthyroidism disease with TT4 top level < 1.4 times the upper normal limit for mild thyrotoxicosis; > 1.4 times the upper normal limit for moderate hyperthyroidism; there is crisis, hyperthyroid heart disease and heart failure, such as severe hyperthyroidism myopathy. [ treatment ] (1 ): due to hyperthyroidism before pregnancy on the fetus of a series of adverse effects, such as undiagnosed hyperthyroidism, should be to be in stable condition of 1～ 3 years after pregnancy for properly, medication ( antithyroid drugs or radioactive iodine) period, should not be pregnant, contraceptive measures should be taken.

    ( 2) 1 ) during treatment of hyperthyroidism in a pregnant woman should be in high-risk outpatient screening and follow-up, pay attention to intrauterine growth rate, positive control of pregnancy induced hypertension syndrome. 2) pregnancy can tolerate mild thyrotoxicosis, the condition of light,杭州市西湖区同济医院甲状腺专科 generally do not have antithyroid drug therapy, because of antithyroid drugs can influence through placenta fetal thyroid function. But the condition of heavy, still should continue with antithyroid drug therapy. In late pregnancy, antithyroid drug dose should not be too large, the general in order to maintain the maternal serum TT4 level does not exceed the upper limit of normal for 1.4 times, also can have mild hyperthyroidism. > 1.4 times the upper limit of normal when using antithyroid drugs. Antithyroid drug, propylthiouracil may not only block the thyroid hormone synthesis, and blockade of T4 in peripheral tissues into the effectiveness of T3, the serum T3 level decreased rapidly. Usual dose of propylthiouracil on 150～ 300mg/d, 15 ～ 30mg/d or methimazole, after the control of hyperthyroidism can be reduced gradually. In 2～ 3 weeks before the expected date of medication, or the use of control with minimal effective dose.

     Propylthiouracil dosage every day to keep under 200mg, methimazole below 20mg, fetal goiter unlikely. In the application of antithyroid drug therapy is combined with thyroid hormone problems controversy, due to thyroid hormone is not easily through the placenta, after use, but increase the anti thyroid drug dose, but combined to eliminate the antithyroid drug induced hypothyroidism and prevention of fetal with antithyroid drugs affecting the occurrence of hypothyroidism or thyroid enlargement. 3) since the antithyroid drug can quickly through the placenta affects fetal thyroid function, some people advocate the antithyroid drug therapy after subtotal thyroidectomy, and achieved good results, but the general opinion of pregnancy should be avoided in thyroidectomy for hyperthyroidism during pregnancy, operation difficulty is greater, postoperative maternal easily complicated with hypothyroidism, parathyroid hormone dysfunction and injury of recurrent laryngeal nerve in operation, and is easy to cause the miscarriage and premature birth. 4)βreceptor blocker propranolol ( propranolol ) application, dosage of 10～ 20mg, 3 times a day. Effect of propranolol on hyperthyroidism in pregnant women is an effective drug treatment, can ease due to an excess of thyroid hormone induced by systemic symptoms. Propranolol effect quickly, good effect, suitable for hyperthyroidism crisis and emergency thyroid operation quick preparation. Although beta blockers in early heart failure or杭州市同济医院看病费用高吗 metabolic acidosis in patients with acute heart failure prompts, under general anesthesia can cause severe hypotension, prolonged use of propranolol can uterine muscle tension, leading to placental dysplasia, and intrauterine growth retardation, so in the hyperthyroidism in pregnancy should not be chosen as the drug of choice. 5) treatment of pregnancy complicated with hyperthyroidism in obstetrics: this news has a total of 2 page of 12