Der Internist

, 52:1158 | Cite as

Schilddrüsenerkrankungen und Schwangerschaft

Schwerpunkt

Zusammenfassung

Jede Schwangerschaft verursacht physiologische Veränderungen des Schilddrüsenstoffwechsels, die von pathologischen Funktionszuständen abgegrenzt werden müssen. Sowohl eine Hypothyreose als auch eine Hyperthyreose können zu Komplikationen im Schwangerschaftsverlauf führen und negative Auswirkungen auf die Entwicklung des Kindes haben. Insbesondere eine mütterliche Hypothyreose ist wegen der Gefahr irreparabler neurokognitiver Entwicklungsstörungen des Feten unter allen Umständen zu vermeiden. Autoimmunthyreopathien spielen in der Schwangerschaft eine besondere Rolle: Die Hashimoto-Thyreoiditis ist mit Fertilitätsstörungen und Fehlgeburtlichkeit assoziiert und die häufigste Ursache für eine neu manifestierte Hypothyreose in der Schwangerschaft. Der M. Basedow nimmt in der Schwangerschaft oftmals einen charakteristischen Verlauf mit Besserung der Schilddrüsenfunktion in der 2. Schwangerschaftshälfte und Exazerbation nach Entbindung. Die transplazentare Passage der mütterlichen TSH-Rezeptor-Antikörper kann zu einer fetalen bzw. neonatalen Hyperthyreose führen.

Schlüsselwörter

Hypothyreose Hyperthyreose Autoimmunthyreoiditis Schilddrüsenknoten Schwangerschaft 

Thyroid illness during pregnancy

Abstract

Pregnancy causes a number of physiological alterations in thyroid hormone metabolism that need to be distinguished from the pathophysiological states of thyroid dysfunction. Both hypothyroidism and thyrotoxicosis may impair the course of pregnancy and may negatively affect the fetus. In particular, maternal hypothyroidism may lead to irreparable and detrimental deficits in the neurocognitive development of the fetus. Autoimmune thyroid disease is the most common cause of thyroid dysfunction in pregnancy. Hashimoto’s thyroiditis is associated with impaired fertility and miscarriage, and may first manifest in pregnancy due to the increased thyroid hormone requirement. Graves’ disease often shows a characteristic course in pregnancy with amelioration of thyrotoxicosis in the second half of pregnancy and exacerbation after delivery. In addition transplacental passage of maternal TSH receptor antibodies may lead to thyrotoxicosis in the fetus and/or newborn.

Keywords

Hypothyroidism Hyperthyroidism Autoimmune thyroid disease Thyroid nodules Pregnancy 

Notes

Interessenkonflikt

Die korrespondierende Autorin weist auf folgende Beziehungen hin:

Merck und Sanofi Aventis (Referententätigkeit und Projektförderung).

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Zentrum für Innere Medizin, Klinik für EndokrinologieBereich Forschung und Lehre des Zentrallabors, Universitätsklinikum EssenEssenDeutschland

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