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임신 전후 갑상선항진증의 진단 및 치료

Diagnosis and Treatment of Hyperthyroidism in Pregnancy

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초록

Thyroid function fluctuates during pregnancy. Thus, assessments of thyroid activity during childbearing years represent an important health metric. Since anti-thyroid drugs are potentially teratogenic, drug dosing and timing should be carefully calculated. Normally, diagnosis and treatment of hyperthyroidism is performed to determine underlying causes (i.e., Graves' disease), to predict disease course and to make appropriate therapeutic decisions. In cases of maternal hyperthyroidism, these same measures also require the insight regarding the relationship between pregnancy and thyroid function, the effects of anti-thyroid drugs on pregnancy outcomes.

Abstract

Thyroid function fluctuates during pregnancy. Thus, assessments of thyroid activity during childbearing years represent an important health metric. Since anti-thyroid drugs are potentially teratogenic, drug dosing and timing should be carefully calculated. Normally, diagnosis and treatment of hyperthyroidism is performed to determine underlying causes (i.e., Graves' disease), to predict disease course and to make appropriate therapeutic decisions. In cases of maternal hyperthyroidism, these same measures also require the insight regarding the relationship between pregnancy and thyroid function, the effects of anti-thyroid drugs on pregnancy outcomes.

참고문헌 (11)

  1. Lambert-Messerlian G, "Firstand second-trimester thyroid hormone reference data in pregnant women : a FaSTER(first-and second-trimester evaluation of risk for aneuploidy)research consortium study", Am J Obstet Gynecol, 199, pp.62~ (2008)[DOI]
  2. Cooper DS, "Hyperthyroidism in pregnancy", Lancet Diabetes Endocrinol, 1, pp.238~249 (2013)
  3. Goodwin TM, "Transient hyperthyroidism and hyperemesis gravidarum : clinical aspects", Am J Obstet Gynecol, 167, pp.648~652 (1992)
  4. Tan JY, "Transient hyperthyroidism of hyperemesis gravidarum", Bjog, 109, pp.683~688 (2002)
  5. Millar LK, "Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism", Obstet Gynecol, 84, pp.946~949 (1994)
  6. Yoshihara A, "Treatment of Graves'disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation", J Clin Endocrinol Metab, 97, pp.2396~2403 (2012)
  7. Andersen SL, "Birth defects after early pregnancy use of antithyroid drugs : a Danish nationwide study", J Clin Endocrinol Metab, 98, pp.4373~4381 (2013)
  8. Laurberg P, "Therapy of endocrine disease : antithyroid drug use in early pregnancy and birth defects : time windows of relative safety and high risk", Eur J Endocrinol, 171, pp.R13~R20 (2014)[DOI]
  9. Bahn RS, "The role of propylthiouracil in the management of Graves' disease in adults : report of a meeting jointly sponsored by the American Thyroid Association and the Food and Drug Administration", Thyroid, 19, pp.673~674 (2009)
  10. Hamburger JI, "Diagnosis and management of Graves' disease in pregnancy", Thyroid, 2, pp.219~224 (1992)
  11. Laurberg P, "Guidelines for TSH-receptor antibody measurements in pregnancy : results of an evidence-based symposium organized by the European Thyroid Association", Eur J Endocrinol, 139, pp.584~586 (1998)

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