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The Research on the Relationship between Hypertension Disorder Complicating Pregnancy and Thyroid Function Decrease

Author: WangJing
Tutor: LiZengYan
School: Tianjin Medical University
Course: Obstetrics and Gynaecology
Keywords: hypertensive disorder complicating pregnancy severepreeclampsia mild preeclampsia thyroid function decrease subclinical thyroidfunction decrease low thyroid hormone levels
CLC: R714.246
Type: Master's thesis
Year: 2013
Downloads: 2
Quote: 0
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BackgroundThe high blood pressure disease of woman when pregnancy is called hypertensive disorders in pregnancy. It is reported that the incidence of hypertensive disorders in pregnancy in foreign countries is6.4%-7.0%, the incidence of preeclampsia is5%. While in China, the average incidence of hypertensive disorders in pregnancy is9.4%.Gestational hypertension disease is seriously endangering the maternal and child health, it’s the main cause of maternal and perinatal disease rate and mortality.Thyroid disease in pregnancy is one of the key problems of internal secretion area and among the medical profession in recent years. Through secrete HCG, gestational trophoblastic irritates matrix hypothyroid, to keep the matrix hypothyroid in a high level which exceeds25%~30%than not gestation. By taking the mother blood T4in placenta iodine formed rT3to supply iodide ion for the development of fetus, meet nervous system development od fetus, but Mother during pregnancy chorionic gonadotropin, thyroid hormone and iodineion level by iodine enzyme activity of a variety of factors, such as thyroid hormone production and the degree of metabolic abnormalities. Gestational hypertension disease damaged the liver and kidney which leads to disturbance function damage of three substance metabolic,but thyroid hormone directly involved that, so the conclusion is that the thyroid function is closed with gestational hypertensive disorders.Purpose:The experiment is that through the test of FT3、FT4and TSH from normal mature pregnant woman, mild preeclampsia and severe preeclampsia,and to compare the level of thyroid hormones by prenatal and postpartum analysis the relationship between low thyroid hormone levels and hypertensive disorders in pregnancy;it’s through blood lipid, albumin and urinary protein quantitative to analyse the correlation with thyroid function, so as to provide a new theoretical basis for clinical diagnosis and treatment.Method:Analysis of Pregnant women who were outpatient obstetric and hospital birth 200cases between December2011and December2012in tianjin medical university general hospital.On the base of the standards of mild preeclampsia and severe preeclampsia divided in three groups:①normal group②Mild preeclampsia③severe preeclampsia group.Three groups have been ruled out high blood pressure, diabetes, heart disease, liver and kidney function is not complete, hyperthyroidism, thyroid function decrease,subclinical thyroid function decrease,endocrine disease history, history of thyroid surgery, medical records is not complete. Compared the patients’ thyroid hormone levels of the three groups and the level of recovery of prenatal postpartum thyroid hormones,and the relationship between blood lipid, albumin and urinary protein quantitative with thyroid function, tracked the result of the heel blood of72hours after birth.Results:1.Thyroid hormones were compared between the three groups, with the aggravation of preeclampsia,FT3, FT4were increased,and TSH was gradually reduced.The most significant was the severe preeclampsia group compared with normal group,the difference was statistically significant (P<0.05).2. As preeclampsia illness aggravating, TC and TG was increased.The severe preeclampsia group was significantly higher than that of the normal group and mild preeclampsia group, the difference was statistically significant (P<0.05). TC, TG and TSH were positively correlated (r=0.216/0.174, P<0.05).3.24-hour urine protein quantitative with FT3, FT4were negative correlation (r=-0.353/0.168, P<0.05). Albumin and FT4and TSH were positively correlated, r=0.166/0.190, P<0.05).4.①Normal group of FT3and FT4were increased compared to prenatal, but there was no statistically significant difference (P>0.05), and TSH was lower, the difference was statistically significant (P<0.05);②mild preeclampsia group of FT3, FT4were increased compared to the preenatal, there was no statistically significant difference (P>0.05), and TSH was reduced, the difference was statistically significant (P<0.05);③severe preeclampsia group of FT3, FT4was increased compared to the prenatal, TSH was lower, the difference was statistically significant (P<0.05). 5. The results of the neonatal heel blood was normal,which shows that the influence of maternal thyroid dysfunction is not important.Conclusion:The patient of severe preeclampsia’s thyroid hormone levels was lower than that of the normal patients,but the lower thyroid hormone levels can worsen the severe preeclampsia, this may be a secondary change, may be associated with hypoalbuminemia and lipid metabolic disorders.Severe preeclampsia who’s the recovery of thyroid hormone levels in postpartum patients’ time is longer, and a part of them was thyroid function decrease or subclinical thyroid function decrease.Hypertensive disorder complicating pregnancy should pay attention to monitor the thyroid function, be diagnosed and treated the thyroid function decrease in time,it will help improve the hypertensive disorder complicating pregnancy’s prognosis.Because of the severe preeclampsia and thyroid function decrease had many similarities in clinical, such as edema, hypoalbuminemia and metabolic disorders, that may be influence each other,so we should pay attention to identify.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy ) > Gestosis > Pregnancy-induced hypertension
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