Duirng Pregnancy Of TSH, TPO-AB, FT4and Testing Pregnant Women And Newborns Complicated By Disease-related Research And Analysis

Background: During pregnancy and after childbirth, the maternal thyroid experienceda series of endocrine and Metabolism.Hemodynamic and immune status have changed.Inthe physiological state of pregnancy, maternal thyroid volume than the previous increase,with a rich blood.Thyroid hormone have increased, the body’s hormone levels, such asHCG (human chorionic gonadotropin), TSH (thyroid stimulating hormone) alsooccurred in waves.At the same time, during pregnancy can also be induced or complicatedby a variety of thyroid diseases.(And its pathogenetic factors are complex), such as Grave’s disease, is the most common cause of hyperthyroidism.And autoimmune thyroiditis(Hashimoto’s) is the most common cause of hypothyroidism.In addition to gestationaltransient thyrotoxicosis and postpartum thyroiditis.During pregnancy, maternal thyroidautoimmune condition also aroused widespread interest.In recent years,research suggeststhat more than pregnancy-related thyroid disease incidence rate rose to10%-15%.Cancause adverse effects on mother and infant.Its etiology is very complex, and endocrine andimmunological have the relations.Pregnancy and childbirth itself leads to changes in Tcells and Th cells subsets.Enhance the immune tolerance during pregnancy.Role of Th2cells predominate, immune tolerance after delivery lift, into Th1cells are dominant.Maylead to autoimmune disease.In addition to environmental factors such as the number ofiodine intake and thyroid autoimmune diseases also have a relationship.Thyroid status andmaternal and child health.Hyperthyroidism can lead to gestational hypertension, prematurebirth, miscarriage, neonatal congenital thyrotoxicosis, hepatosplenomegaly,craniosynostosis, ADHD and other adverse consequences.Hypothyroidism is the impact offetal growth and development, especially the brain, mental development.And the cause ofneonatal respiratory difficulties, sleepiness, special face, myxedema, serious complicationssuch as low tension.Although pregnancy is high risk of thyroid disease, and thyroiddysfunction on mother-to-child has obviously harm, China still lacks normative before andduring pregnancy thyroid function screening, monitoring system and effective treatment,intervention measures.The energy may focus on less error-prone, as many times as thedetection of hepatic, renal function.Neglecting to examination of thyroid function andthyroid autoantibodies.Therefore, this study is committed to the investigation, analysis ofpregnant women, the incidence of thyroid disease, Current treatment of thyroid diseaseand thyroid dysfunction on maternal and child. To improve the understanding of thepregnant women, the corresponding disease. Domestic and foreign research for pregnancy hyperthyroidism treatment goals: serum T4levels to maintain a minimum dose ofanti-thyroid drugs in the upper limit of normal, and for hypothyroidism, the goal oftreatment is hormone replacement, TSH levels remained between0.5-2.5mU/L.Objective:1502cases of maternal thyroid function screening statistics in abnormalthyroid function and thyroid autoantibodies (TPO-Ab, TGAb) negative incidence.Observation of thyroid dysfunction on maternal and fetal. Investigate the treatment ofpregnant women for thyroid disease and related outcomes. Investigate the clinicalsignificance, analysis of the maternal physiological and pathological conditions, thyroidhormone and TSH fluctuations and positive thyroid autoantibodies (TPO-Ab-positiveserum TGAb).Methods: A retrospective analysis from January1,2009to October1,2011inour hospital prenatal care of pregnant women in1502cases, all cases have been the line ofTSH, FT3and FT4, TPOAb in serum TGAb the level of detection, thyroid dysfunction ofpregnant women continue to monitor the FT4level until delivery, and record bloodpressure, weight, BMI, and other clinical and laboratory index.Results: the study data prompted this group of pregnant women in gestationalthyroid dysfunction cases for181patients, all pregnant women accounted for12.1%,thyroid autoantibodies positive cases in165patients (TPOAb (+),30cases), subclinicalhypothyroidism and subclinical hypothyroidism (6.47%)(4.43%) the mostcommon.Clinical hyperthyroidism in5cases (0.3%) subclinical hyperthyroidism in13cases (0.9%).Clinical and subclinical hypothyroidism in pregnant women compared withthe control group, the incidence of anemia clinical hypothyroidism decreased, gestationalhypertension, intrauterine growth retardation (IUGR) incidence rate increased significantly,and the prevalence of gestational diabetes mellitus has increased significantly;hyperthyroidism in pregnant women compared with the control group, gestationalhypertension and gestational diabetes mellitus incidence rises.For perinatal complications,hypothyroidism in pregnant women with total cesarean and due to fetal distress thecesarean section cases rise; and hyperthyroidism in a pregnant woman with premature,neonatal complications (neonatal thyrotoxicosis) increased incidence.As for the risk ofperinatal complications assessment revealed: hypothyroidism pregnancy due to fetaldistress cesarean risk and IUGR risk increased significantly, and hyperthyroidism in apregnant woman with premature birth, gestational diabetes significantly elevated risks.Conclusion: our country in pregnant women with gestational thyroid function and thyroid autoantibodies abnormalities in common, the data seem to hypothyroidism,pregnant women are more prone to IUGR, cesarean section has risen, their Apgar score islow, newborn mental development needs further follow-up, and the risk ofhyperthyroidism, pregnant women, preterm birth, gestational hypertension, gestationaldiabetes increased,neonatal complications was also significantly higher. Therefore, thepre-pregnancy and pregnancy should be routine screening of thyroid function andautoantibodies. The timely intervention of thyroid disease during pregnancy, management,Maternal and Child Health.