Zusammenfassung
Die Abklärung der Schilddrüsenfunktion hat eine hohe Bedeutung im Rahmen der Fertilität, der Schwangerschaft und Stillzeit. Die Diagnostik der Schilddrüsenerkrankungen erfolgt klinisch und laboranalytisch. Im Rahmen der Kinderwunschbehandlung kann insbesondere die latente Hypothyreose zu Zyklusanomalien und Lutealphaseninsuffizienz führen. Zirkulierende Schilddrüsenantikörper sind mit einer erhöhten Abortrate assoziiert. Eine in der Schwangerschaft nicht suffizient eingestellte Schilddrüsensituation bedeutet nicht nur für die Mutter ein erhöhtes Risiko für Schwangerschaftserkrankungen, sondern auch ein erhebliches Risiko für das ungeborene Kind. Die suffiziente Diagnostik vor Eintritt der Schwangerschaft ist daher anzustreben. Post partum können unterschiedliche Verläufe von Schilddrüsenfunktionsstörungen beobachtet werden. Bei unklarem Beschwerdebild in der Postpartalzeit ist an die Kontrolle der Schilddrüsenfunktion zu denken. Die systematische Diagnostik und Therapie von Schilddrüsenfunktionsstörungen ist Gegenstand dieser Arbeit.
Abstract
The thyroid gland is an important organ with regard to fertility, pregnancy and lactation. The diagnosis of thyroid disorders is done clinically and by laboratory analysis. In cases of subfertility especially subclinical hypothyroidism can lead to irregular cycles and luteal phase insufficiency. Circulating thyroid antibodies can be associated with an increased rate of spontaneous abortions. Thyroid function has to be well controlled during pregnancy to avoid severe problems for the mother (e.g. pre-eclampsia) as well as for the fetus. Adequate diagnostic assessment before pregnancy should be the goal. Different thyroid disorders can be observed in the postpartum patient. In unclear clinical situations during the postpartum period, consideration should be given to monitoring thyroid function. The systematic diagnostic work-up and therapy are described in this review.
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Ludwig, M., Schulte, H.M. Schilddrüse bei unerfülltem Kinderwunsch, in Schwangerschaft und Stillzeit. Gynäkologische Endokrinologie 3, 45–54 (2005). https://doi.org/10.1007/s10304-004-0094-1
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DOI: https://doi.org/10.1007/s10304-004-0094-1