Kafukufuku wofalitsidwa ku British Medical Journal wasonyeza kuti kuchiza matenda a hypothyroidism pa nthawi ya mimba kungachepetse chiopsezo chotenga padera. Pa nthawi yomweyi, ofufuza adapeza kuti amayi omwe amachiritsidwa ndi subclinical hypothyroidism amakumana ndi chiopsezo chowonjezereka chokhala ndi mimba , monga kubereka msanga, preeclampsia, ndi matenda a shuga.
Pa Phunziro
Kafukufukuyu anayezetsa akazi oposa 5,000 omwe anali ndi matenda opatsirana pogonana, omwe ali ndi tizilombo toyambitsa matenda (TSH) pakati pa 2.5 ndi 10 mIU / L. Ofufuzawa adapeza kuti amayi omwe adachiritsidwa ndi mankhwala a chithokomiro oterewa anali ndi 38 peresenti yochepa yopititsa padera, poyerekeza ndi gulu losagonjetsedwa. Chofunika kwambiri, zotsatira zake zimangogwiritsidwa ntchito kwa amayi omwe anali ndi TSH mlingo wa 4.1 mIU / L wapamwamba asanayambe kuchipatala.
Amayi omwe anali ndi masekeli a TSH kuchokera ku 2.5 mpaka 4.0 mIU / L sanaoneke pangozi yochepetsedwa padera. Ndipotu, amayiwa anali ndi chiopsezo chachikulu kwambiri chokhala ndi matenda opatsirana mwakayakaya-zomwe zingayambitse pre-eclampsia.
Preeclampsia ndi mkhalidwe umene ungapangitse mimba yomwe imayambitsa kuthamanga kwa magazi. Preeclampsia ikhoza kuwonetsa kuwala kwa chiwindi, chomwe chingayambitse chiwindi kapena impso kulephera, mtima wosagonjetsedwa, kugwidwa, kugwedezeka, komanso kungakhale koopsa kwa amayi ndi mwana.
Kusintha kwa Malangizo
Phunziroli likuwonetsa kusintha kwa malingaliro kwa amayi panthawi yoyembekezera. M'mbuyomu, chithandizo chalimbikitsidwa kwa amayi apakati omwe ali ndi hypothyroidism omwe majeremusi oyambitsa mahomoni (TSH) adagwa pakati pa 2.5 ndi 4.0 mIU / L.
Bungwe la American Thyroid Association (ATA) linatulutsanso malangizo atsopano mu 2017 omwe akugwirizana ndi malingaliro a kufufuza kwa British Medical Journal .
Malingana ndi ATA, chifukwa cha umboni wakuti zotsatira za mimba zingakhudzidwe kwambiri, malangizo a akatswiri akuthandizira chithandizo kwa amayi omwe ali ndi overt hypothyroidism, otchedwa TSH mlingo pamwamba pa 4.1 mIU / L.
Kuchiza kungawonongeke kwa amayi omwe ali ndi subclinical hypothyroidism-TSH pakati pa 2.5 ndi 4.0 mIU / L-ngati ali ndi ma antibodies a chithokomiro a peroxidase (TPO) omwe ali umboni wa Hashimoto's thyroiditis.
Malingana ndi wolemba woyambitsa maphunziro, Spyridoula Maraka, MD:
Kupitiriza kupereka chithandizo chamatenda a chithokomiro kuti achepetse chiopsezo chotenga mimba ndiloyenera kwa amayi omwe ali ndi TSH ya 4.1-10.0 mIU / L. Komabe, chifukwa cha kuchepa kwaling'ono kwa amayi omwe ali ndi maeresi a TSH ochepa a 2.5-4.0 mIU / L, ndipo poyerekeza ndi zomwe zingatheke kuwonjezeka kwa zochitika zina zovuta, chithandizo chiyenera kukhala choletsedwa mu gulu lino.
Monga tawonetsera, malangizo a ATA amalimbikitsa kuti madokotala aziganiza kuti TPO ndi mayi wa amayi pa chisankho chochiza matenda a hypothyroidism. Chithandizo chingaperekedwe kwa amayi omwe ali TPO-positive ndipo ali ndi TSH mlingo pakati pa 2.5 ndi 4.0 mIU / L.
Kodi Magulu Omwe Amagwiritsira Ntchito Magulu Omwe Amagwiritsira Ntchito Magulu Achipatala?
Tizilombo toyambitsa matenda tizilombo toyambitsa matenda timakhudza pafupifupi 15 peresenti ya amayi a ku America ali ndi pakati.
Kukhala ndi mavitamini ambiri a chithokomiro n'kofunikira kuti mwana athandizidwe bwino, makamaka m'zaka zitatu zoyambirira, pamene mayi amapereka mahomoni a chithokomiro kwa mwana wosabadwayo. Pambuyo pa trimestre yoyamba, chithokomiro cha fetus chinayamba ndipo chimayamba kutulutsa mahomoni otchedwa chithokomiro.
Matenda opatsirana pogonana pa nthawi yomwe ali ndi pakati amakhala ndi zotsatira zosiyana siyana za mimba, kuphatikizapo kutaya pathupi, kuperewera kwa thupi, kuchepa kwa thupi, kubala, pre-eclampsia, kugonana ndi matenda a shuga, komanso kuchepetsa ana a IQ.
Zotsatira Zanu Zotsatira?
Ngati muli ndi pakati ndipo muli ndi subclinical hypothyroidism-koma ndinu TPO-osayankhula-ofufuza amalimbikitsa kukambirana ndi dokotala wanu. Malingana ndi zomwe apeza:
Kuwongolera njira yopangira zisankho kwa amayi apakati omwe ali ndi subclinical hypothyroidism, odwala amalimbikitsidwa kugwiritsira ntchito njira yogwirizanitsa zokambirana. Ndi njirayi, odwala angakambirane ndi odwala kuti asakayikire kumbuyo kwa malangizidwe a mankhwala ndi kufufuza zomwe zimafunikira kwa iwo pakupanga zisankho zokhudzana ndi thanzi lawo ndi cholinga chofuna kusankha chithandizo cha mankhwala omwe angafanane nawo.
Mawu Ochokera
Ndikofunika kufotokozera kuti phunziroli linali lowonetserako, osati kuyesedwa kwachidziwitso kuchipatala. Kuti izi zitheke, kufufuza kwina kuli kofunika kuti mudziwe ngati kutulutsa mahomoni a chithokomiro m'malo mwa amayi oyembekezera kumapangitsa kuti akhale ndi mimba yabwino, kapena kuti afotokoze mfundo yowonongeka kuti athe kupereka chithandizo kwa amayi omwe ali ndi subclinical hypothyroidism pa nthawi ya mimba.
Chinthu china chimene chiyenera kupitilira kuphunzira ndi nthawi ya chithandizo. Kutuluka padera kumakhala kofala m'nthawi ya trimester yoyamba, nthawi yomwe mwanayo amadalira mayiyo ngati gwero lokha la mahomoni a chithokomiro. Ofufuzawa anaganiza kuti ndizotheka kuti chithandizo cha subclinical hypothyroidism chikhale chofunika pa nthawi yoyamba yokha ya mimba. Kafukufuku wambiri pa nkhani izi zidzakuthandizira kufotokoza nkhaniyi patsogolo.
> Zotsatira:
> Elizabeth AE, et. al. "2017 Malangizo a bungwe la American Thyroid Association la Kuzindikira ndi Kusamalira Matenda a Chithokomiro Pakati pa Mimba ndi Postpartum." Chithokomiro, Vesi 27, Nambala 3, 2017. Online: http://online.liebertpub.com/doi/pdfplus/10.1089/thy.2016.0457
> Spyridoula M et. al. "Chithandizo cha mahomoni a chithokomiro pakati pa amayi apakati omwe ali ndi subclinical hypothyroidism: United States." British Medical Journal. J 2017; 356: i6865 do: 10.1136 / bmj.i6865 2017. Online: http://www.bmj.com/content/bmj/356/bmj.i6865.full.pdf