目的分析妊娠期亚临床甲状腺功能减退症及过氧化物酶抗体(TPOAb)阳性对妊娠结局及胎儿结局的影响。方法随机选择2018年1~12月至我院分娩的60例妊娠期亚临床甲状腺功能减退症及TPOAb阳性孕妇作为观察组,随机选择同期至我院分娩的60例健...目的分析妊娠期亚临床甲状腺功能减退症及过氧化物酶抗体(TPOAb)阳性对妊娠结局及胎儿结局的影响。方法随机选择2018年1~12月至我院分娩的60例妊娠期亚临床甲状腺功能减退症及TPOAb阳性孕妇作为观察组,随机选择同期至我院分娩的60例健康孕妇作为对照组,观察两组产妇产前的促甲状腺激素(TSH)、血清游离甲状腺素(FT4)、血清游离三碘甲腺原氨酸(FT3)等甲状腺功能相关指标,比较两组孕妇的分娩方式及分娩并发症发生率,记录两组新生儿的结局、体重以及1 min Apgar评分情况。结果观察组孕妇的TSH、TPOAb水平明显高于对照组,差异有统计学意义(P<0.05);两组孕妇的FT3、FT4水平比较,差异无统计学意义(P>0.05)。观察组的剖宫率为36.67%,明显高于对照组的20.00%,差异有统计学意义(P<0.05),两组孕妇的自然分娩率和产钳助产率比较,差异无统计学意义(P>0.05)。观察组孕妇的先兆流产发生率为13.33%,明显高于对照组的3.33%,差异有统计学意义(P<0.05)。观察组孕妇的早产发生率为16.37%,明显高于对照组的5.00%,差异有统计学意义(P<0.05)。两组孕妇的胎儿窘迫、胎膜早破、胎盘早剥、产后出血发生率比较,差异无统计学意义(P>0.05)。观察组的低出生体重儿占16.67%,明显高于对照组的5.00%,差异有统计学意义(P<0.05)。两组新生儿的巨大儿、窒息、围生儿死亡发生率比较,差异无统计学意义(P>0.05)。观察组的新生儿体重和1 min Apgar评分均低于对照组,差异有统计学意义(P<0.05)。结论妊娠期亚临床甲状腺功能减退症及TPOAb阳性会增加孕妇剖宫产、早产和先兆流产、低体重新生儿的发生率,并降低新生儿出生评分,对于妊娠结局和胎儿结局均有不良影响。展开更多
Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, ...Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distres展开更多
目的:分析早期先兆流产患者安胎结局与甲状腺功能的相关性,初步探讨甲状腺功能状况对早期先兆流产患者安胎结局的影响,为早期干预甲状腺功能及用药提供数据支撑。方法:回顾性研究532例早期先兆流产患者,分为安胎成功组(402例)及安胎失败...目的:分析早期先兆流产患者安胎结局与甲状腺功能的相关性,初步探讨甲状腺功能状况对早期先兆流产患者安胎结局的影响,为早期干预甲状腺功能及用药提供数据支撑。方法:回顾性研究532例早期先兆流产患者,分为安胎成功组(402例)及安胎失败组(130例),通过测定甲状腺功能(TSH),和随访患者安胎结局,评估甲状腺功能状况与安胎结局的相关性。结果:安胎成功组共402例,105例正服用优甲乐,182例促甲状腺激素(TSH)<2.5 m IU/L,42例TSH 2.5~5 m IU/L,3例TSH≥10 m IU/L;安胎失败组共130例,28例正服用优甲乐,48例TSH<2.5 m IU/L,20例TSH2.5~5 m IU/L,4例TSH≥10 m IU/L。结论:随着促甲状腺激素(TSH)值升高,安胎成功率逐渐降低,安胎失败率逐渐上升;是否使用优甲乐对安胎结局无明显影响。展开更多
文摘目的分析妊娠期亚临床甲状腺功能减退症及过氧化物酶抗体(TPOAb)阳性对妊娠结局及胎儿结局的影响。方法随机选择2018年1~12月至我院分娩的60例妊娠期亚临床甲状腺功能减退症及TPOAb阳性孕妇作为观察组,随机选择同期至我院分娩的60例健康孕妇作为对照组,观察两组产妇产前的促甲状腺激素(TSH)、血清游离甲状腺素(FT4)、血清游离三碘甲腺原氨酸(FT3)等甲状腺功能相关指标,比较两组孕妇的分娩方式及分娩并发症发生率,记录两组新生儿的结局、体重以及1 min Apgar评分情况。结果观察组孕妇的TSH、TPOAb水平明显高于对照组,差异有统计学意义(P<0.05);两组孕妇的FT3、FT4水平比较,差异无统计学意义(P>0.05)。观察组的剖宫率为36.67%,明显高于对照组的20.00%,差异有统计学意义(P<0.05),两组孕妇的自然分娩率和产钳助产率比较,差异无统计学意义(P>0.05)。观察组孕妇的先兆流产发生率为13.33%,明显高于对照组的3.33%,差异有统计学意义(P<0.05)。观察组孕妇的早产发生率为16.37%,明显高于对照组的5.00%,差异有统计学意义(P<0.05)。两组孕妇的胎儿窘迫、胎膜早破、胎盘早剥、产后出血发生率比较,差异无统计学意义(P>0.05)。观察组的低出生体重儿占16.67%,明显高于对照组的5.00%,差异有统计学意义(P<0.05)。两组新生儿的巨大儿、窒息、围生儿死亡发生率比较,差异无统计学意义(P>0.05)。观察组的新生儿体重和1 min Apgar评分均低于对照组,差异有统计学意义(P<0.05)。结论妊娠期亚临床甲状腺功能减退症及TPOAb阳性会增加孕妇剖宫产、早产和先兆流产、低体重新生儿的发生率,并降低新生儿出生评分,对于妊娠结局和胎儿结局均有不良影响。
文摘Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distres
文摘目的:分析早期先兆流产患者安胎结局与甲状腺功能的相关性,初步探讨甲状腺功能状况对早期先兆流产患者安胎结局的影响,为早期干预甲状腺功能及用药提供数据支撑。方法:回顾性研究532例早期先兆流产患者,分为安胎成功组(402例)及安胎失败组(130例),通过测定甲状腺功能(TSH),和随访患者安胎结局,评估甲状腺功能状况与安胎结局的相关性。结果:安胎成功组共402例,105例正服用优甲乐,182例促甲状腺激素(TSH)<2.5 m IU/L,42例TSH 2.5~5 m IU/L,3例TSH≥10 m IU/L;安胎失败组共130例,28例正服用优甲乐,48例TSH<2.5 m IU/L,20例TSH2.5~5 m IU/L,4例TSH≥10 m IU/L。结论:随着促甲状腺激素(TSH)值升高,安胎成功率逐渐降低,安胎失败率逐渐上升;是否使用优甲乐对安胎结局无明显影响。
