članak: 1 od 1  
Medicinski časopis
2011, vol. 45, br. 3, str. 32-37
jezik rada: srpski
prikaz
doi:10.5937/medcas1103032B

Tireoidna žlezda i trudnoća
Klinika za ginekologiju i akušerstvo, Klinički centar, Kragujevac

e-adresa: marija_bicanin@hotmail.com

Sažetak

Tireoidna žlezda ima veoma značajnu ulogu u funkcionisanju organizma, a posebno u razvoju mnogih tkiva i organa u toku intrauterinog razvoja. Napredak u razumevanju fiziologije funkcionisanja štitaste žlezde u normalnoj trudnoći, još više je istakao značaj poremećaja u njenoj funkciji za nepovoljan akušerski ili neonatalni ishod trudnoće. Normalnu trudnoću karakteriše znatno izmenjeno funkcionisanje tireoine žlezde, koje remeti testove tireoidne funkcije, tako da se njihove referentne vrednosti za stanja izvan trudnoće ne mogu koristiti tokom gestacije. Stimulativni uticaj humanog horionskog gonadotropina (HCG) na tireoidnu žlezdu, sa posledičnom redukcijom koncentracije tireostimulišućeg hormona (TSH) mora se uvek uzeti u obzir prilikom evaluacije tireoidnih funkcionalnih testova, posebno tokom prvog trimestra trudnoće. Ispravna interpretacija koncentracije TSH, u vezi sa slobodnim tiroksinom (FT4) i Anti TPOAb je važnija za razlikovanje fizioloških stanja za trudnoću, od onih koje iziskuju medicinski tretman (Gravesova bolest, Hashimoto tireoiditis). Gravesov hipertireoidizam povezan je sa povećanim rizikom maternalnih i fetalnih komplikacija, a adekvatnim tretmanom antitireoidnim lekovima moguće je ublažiti ove neželjene efekte. Izuzetno je značajno: a) pravilno prepoznati etiologiju poremećaja funkcije tiroidne žlezde i b) primeniti odgovarajuću terapiju dijagnostikovanog poremećaja, bilo da je reč o hipofunkciji bilo o hiperfunkciji tiroidne žlezde.

Ključne reči

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