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Advisor(s)
Abstract(s)
Introdução: O hipertiroidismo na gravidez, apesar de pouco prevalente, tem sido
associado a diversas complicações no decorrer da gestação, para a mãe e para o recémnascido. Daí o seu diagnóstico e tratamento serem fundamentais.
Objetivos: O presente trabalho tem como objetivo definir as principais complicações
associadas ao hipertiroidismo na gravidez, tanto maternas como fetais, esclarecer
qual a influência do tratamento nas mesmas, assim como perceber qual a terapêutica
ideal para esta patologia na gravidez.
Métodos: Para a elaboração desta monografia, procedeu-se à pesquisa de artigos nas
plataformas PubMed e Elsevier, com as seguintes palavras-chave: hyperthyroidism,
pregnancy, treatment, outcomes. Foram também utilizados 2 operadores booleanos
“AND” e “OR” nas diversas combinações.
Resultados: Foram analisados 14 artigos que abordavam as complicações clínicas
do hipertiroidismo na gravidez, o seu rastreio, diagnóstico e as opções de tratamento.
No geral foram identificadas várias consequências, particularmente, o parto prétermo, pré-eclampsia, hipertensão gestacional, restrição do crescimento intrauterino,
baixo peso à nascença, hipertiroidismo neonatal e doenças neurocognitivas na
criança, entre outras. Não existe um consenso quanto ao rastreio desta patologia na
gravidez nem ao tipo de tratamento a usar, contudo a maioria dos estudos considera
que o tratamento deve ser feito com fármacos antitiroideus, nomeadamente
propiltiouracilo no primeiro trimestre e metimazol nos restantes.
Conclusão: O hipertiroidismo está associado a diversas implicações clínicas e
resultados adversos na gravidez. O tratamento com fármacos antitiroideus é
fundamental e deve ser discutido com todas as grávidas diagnosticadas com esta
doença. Assim, a utilização de propiltiouracilo e metimazol, como fármacos nestas
grávidas, ainda não é consensual. A realização de rastreio universal ou direcionado
desta patologia na gravidez também não é consensual, mas poderá ser importante
para a saúde destas grávidas. Sendo assim, devem ser realizados mais estudos, de
modo a promover práticas clínicas uniformes e baseadas na evidência científica.
ntroduction: Hyperthyroidism in pregnancy, although not very prevalente, has been associated with several complications during pregnancy, for the mother and the newborn. Hence its diagnosis and treatment are fundamental. Aims: The presente work aims to define the complications associated with hyperthyroidism in pregnancy, both maternal and fetal, to clarify the influence of the treatment on them, as well as to understand the ideal therapy for this pathology in pregnancy. Methods: This work was based on the research of articles on the PubMed and Elsevier platforms, with the following keywords: hyperthyroidism, pregnancy, treatment, outcomes. Two boolean operators “AND” and “OR” were also used in diferente combinations. Results: This study analised 14 articles that adressed the clinical complications of hyperthyroidism in pregnancy, its screening, diagnosis and treatment options. In general, several consequences were identified, particularly preterm delivery, preeclampsia, gestational hypertension, intrauterine growth restriction, low birth wegth, neonatal hyperthyroidism and neurocognitive diseases in children, among others. There is no consensus regarding the screening of this pathology in pregnancy or the type of treatment to use, however most studies consider that the treatment should be done with antithyroid drugs, namely, propylthiouracil in the first trimester and methimazole in the rest. Conclusion: Hyperthyroidism is associated with several clinical implications and adverse pregnancy outcomes. Treatment with antithyroid drugs is essencial and should be discussed with all pregnant women diagnosed with this disease. Most authors agree that the treatment should be done with propylthiouracil and methimazole, however this practice still differs among clinicians. The performance of universal or targeted screening for this pathology during pregnancy is also not consensual, but it could be a benefit. Therefore, further studies should be carried out in order to promote uniform clinical practices based on scientific evidence.
ntroduction: Hyperthyroidism in pregnancy, although not very prevalente, has been associated with several complications during pregnancy, for the mother and the newborn. Hence its diagnosis and treatment are fundamental. Aims: The presente work aims to define the complications associated with hyperthyroidism in pregnancy, both maternal and fetal, to clarify the influence of the treatment on them, as well as to understand the ideal therapy for this pathology in pregnancy. Methods: This work was based on the research of articles on the PubMed and Elsevier platforms, with the following keywords: hyperthyroidism, pregnancy, treatment, outcomes. Two boolean operators “AND” and “OR” were also used in diferente combinations. Results: This study analised 14 articles that adressed the clinical complications of hyperthyroidism in pregnancy, its screening, diagnosis and treatment options. In general, several consequences were identified, particularly preterm delivery, preeclampsia, gestational hypertension, intrauterine growth restriction, low birth wegth, neonatal hyperthyroidism and neurocognitive diseases in children, among others. There is no consensus regarding the screening of this pathology in pregnancy or the type of treatment to use, however most studies consider that the treatment should be done with antithyroid drugs, namely, propylthiouracil in the first trimester and methimazole in the rest. Conclusion: Hyperthyroidism is associated with several clinical implications and adverse pregnancy outcomes. Treatment with antithyroid drugs is essencial and should be discussed with all pregnant women diagnosed with this disease. Most authors agree that the treatment should be done with propylthiouracil and methimazole, however this practice still differs among clinicians. The performance of universal or targeted screening for this pathology during pregnancy is also not consensual, but it could be a benefit. Therefore, further studies should be carried out in order to promote uniform clinical practices based on scientific evidence.
Description
Keywords
Endocrinologia Gravidez Hipertiroidismo Implicações Clínicas Outcomes Fetais Tiróide Tratamento