Summary
Screening for thyroid dysfunction is recommended among certain groups of women, who plan a pregnancy, for example women with history of hyperthyroid or hypothyroid disease, with type 1 diabetes or other autoimmune disorders or women with previous therapeutic head or neck irradiation, in the case of infertility. Management of thyroid disease during pregnancy requires special consideration because pregnancy induces major changes in thyroid function, and maternal thyroid disease can have adverse affects on the pregnancy and the foetus. Under ideal conditions there is a cooperation among several healthcare professionals, such as endocrinologists, nuclear medicine physicians, gynaecologists, neonatologists and if necessary surgeons. This article surveys the physiological and pathological changes of thyroid, their diagnosis and therapy in the case of women in childbearing age, women with unfulfilled desire to have children, pregnant women, as well as women after delivery.
Zusammenfassung
Bei bestimmten Patientengruppen, Frauen mit vorbekannten Schilddrüsenerkrankungen, mit Autoimmunerkrankungen, insbesondere Diabetes mellitus Typ 1, Z. n. Kopf- und Halsbestrahlungen sowie Infertilität sollte bereits präkonzeptionell bezüglich einer etwaigen Schilddrüsenfehlfunktion untersucht und aufgeklärt werden. Sowohl in der Diagnostik als auch in der Therapie muss bei schwangeren und stillenden Frauen bedacht werden, dass zwei Patienten behandelt werden – die Frau und ihr (ungeborenes) Kind. Daher muss eine Balance zwischen effektiver Diagnostik und Therapie beziehungsweise nur minimaler Gefährdung des Kindes gefunden werden. Optimalerweise erfolgt eine interdisziplinäre Zusammenarbeit zwischen Endokrinologen, Nuklearmediziner, Gynäkologen, Neonatologen und ggf. auch Chirurgen. Der folgende Artikel gibt einen Überblick über die physiologischen und pathologischen Veränderungen der Schilddrüse sowie deren Diagnostik und Therapie bei Frauen im gebärfähigen Alter, mit unerfülltem Kinderwunsch, bei Schwangeren sowie bei Frauen nach der Geburt.
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Mayr, J., Kohlfürst, S., Gallowitsch, HJ. et al. Schilddrüse und Schwangerschaft. Wien Med Wochenschr 160, 186–193 (2010). https://doi.org/10.1007/s10354-010-0760-y
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DOI: https://doi.org/10.1007/s10354-010-0760-y