妊娠合并甲状腺功能亢进54例临床分析(2)
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产科处理:按高危妊娠管理:(1)胎儿已成熟,甲亢病情稳定, 争取阴道分娩,缩短第二产程;(2)阴道分娩时,严密注意产程进展,如发生胎头腑屈困难而呈高直位时,应行剖宫产术;(3)分娩及剖宫产术中、术后防止甲亢危象;(4)婴儿出生时留脐血查TSH、FT3、FT4以明确甲状腺功能是否正常。
妊娠与甲亢可以相互影响,妊娠甲亢极易造成漏诊,延误治疗。因此,在孕期出现甲亢高代谢症群:如心悸、怕热、多汗、体重下降或体重不随妊娠月数而增加、手抖、乏力等者应疑甲亢,及时查FT3、FT4以明确甲亢的诊断,治疗过程中注意监测甲状腺功能,注意药物的副作用,如药物过敏、白细胞减少等,并定期产前检查,随时监测孕妇、胎儿情况,确保甲亢病情稳定、母婴平安。
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【收稿日期】 2011-03-01
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