在怀孕期间优化levothyroxine治疗亚临床甲状腺功能低下症
Ulrike Gottwald-Hostalek1, George J Kahaly2
1Merck Healthcare KGaA, Darmstadt, Germany.
Current medical research and opinion
|October 28, 2023
概括
在怀孕期间的亚临床甲状腺功能低下症 (SCH) 会增加流产等风险. 用levothyroxine (LT4) 治疗可以减少这些不良结果,强调正确的患者坚持和医生管理.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
背景情况:
- 怀孕显著增加了甲状腺需求,可能导致新的或恶化的甲状腺功能低下症.
- 亚临床甲状腺功能低下症 (SCH) 影响高达3%的怀孕,带来风险.
- 失控的SCH与流产,孕前症和妊娠期糖尿病有关.
研究的目的:
- 为了突出怀孕期间未经治疗的亚临床甲状腺功能低下症的风险.
- 为了强调Levothyroxine (LT4) 治疗SCH在孕妇中的好处.
- 强调在怀孕期间遵守和基于指导方针的SCH管理的重要性.
主要方法:
- 对SCH在怀孕期间的系统审查和元分析的审查.
- 对SCH治疗当前管理指南的分析.
- 讨论Levothyroxine (LT4) 剂量定位和配方方面的考虑.
主要成果:
- 强有力的证据将不受控制的SCH与不良妊娠结果联系在一起.
- 优化妊娠TSH范围的Levothyroxine (LT4) 治疗可以降低这些风险.
- 坚持LT4治疗对于有效管理至关重要.
结论:
- 建议使用levothyroxine (LT4) 治疗SCH的孕妇,特别是患有高TSH或阳性铁氧化酶抗体的孕妇.
- 精确的LT4定位,可能有助于新的配方,是管理SCH的关键.
- 对正确使用LT4的医生和患者的教育对于最佳妊娠结果至关重要.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.7K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.7K
Functions of Thyroid Hormones
2.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.8K
Adrenergic Antagonists: ɑ and β-Receptor Blockers
496
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
496
The Thyroid Gland
3.9K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
3.9K
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
Hypertension IV: Drug Therapy and Lifestyle Modifications
12
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
12


