The thyroid gland is an endocrine organ in the body that controls the speed of energy use, makes proteins, and regulates the body's sensitivity to other hormones. Its dysfunction is mainly hyperthyroidism, hypothyroidism, subclinical hypothyroidism, which is a common disease in the population, especially in pregnant women. Among them, hypothyroidism has the closest relationship with pregnancy, and the impact on the fetus is also the biggest.
The clinical examination items related to Jiagong are mainly:
1. Free T3, free T4: Not affected by thyroid hormone binding protein, directly reflecting thyroid function status, both elevated in hyperthyroidism; reduced in hypothyroidism, pituitary dysfunction and severe systemic diseases.
2. Serum total thyroxine TT4: is the most basic screening test to determine thyroid function.
3. Serum total triiodothyronine TT3: The increase of serum TT3 and TT4 concentration is mainly seen in hyperthyroidism, together with FT3, FT4 can be used in the diagnosis of hyperthyroidism, hypothyroidism, disease assessment, efficacy monitoring.
4. Determination of thyroid-stimulating hormone TSH: TSH is secreted by the anterior pituitary gland, and TSH in the blood is a sensitive test reflecting the hypothalamic-pituitary-thyroid axis function, especially for the diagnosis of subclinical hyperthyroidism and subclinical hypothyroidism.
5. Thyroglobulin antibodies (TGA) and thyroid microsomal antibodies (TMA): TGA and TMA in serum are the two major specific thyroid autoantibodies. TGA and TMA are elevated in autoimmune thyroid diseases, and other thyroid diseases and healthy people can be detected in the blood. TGA is a specific diagnostic index for chronic lymphocytic thyroiditis, which is often significantly increased. Abnormal and recurrent miscarriage It also has a relationship.
In the early stage of pregnancy, due to changes in hormone levels in the body, the results of the test of individual pregnant women may have a tendency to hyperthyroidism. If the function is normal after one month, then there is no need to pay attention to it; if the hyperthyroidism is still indicated after the review, the endocrinology should be treated. If the hypothyroidism is suggestive, it needs to be taken seriously. Once diagnosed, medication is needed. Youjiale is the most common hypothyroidism replacement drug. Untreated women who have hypothyroidism can increase the incidence of miscarriage, fetal brain development, and postnatal dysplasia. For example, only antibodies (TPOAb, TGAb) are positive, and three items of thyroid function (FT3, FT4, and TSH) are negative. You can apply the prevention of hypothyroidism as appropriate, and review it regularly. Patients with positive antibodies should avoid high iodine diet, because the large intake of iodine will promote the increase of antibody and increase the incidence of hyperthyroidism or hypothyroidism.