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Avaliação bioquímica da função tiroideia na gravidez
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Durante a gravidez há alterações fisiológicas no organismo da grávida que obrigam a glândula tiroideia a um esforço acrescido.
Até cerca das 20 semanas de gestação a tiroide fetal não sintetiza as hormonas necessárias para o desenvolvimento do feto pelo que este necessita das hormonas tiroideias produzidas pela mãe. As hormonas da tiroide são indispensáveis ao desenvolvimento do sistema nervoso central fetal. Um défice destas pode traduzir-se, mais tarde, num atraso cognitivo ou dificuldades de aprendizagem da criança.
As doenças mais frequentes causadas pelas alterações de produção das hormonas são o hipotiroidismo e o hipertiroidismo.
O hipotiroidismo é caracterizado pela carência materna de hormonas tiroideias podendo atingir mais de 3% das gestações.
Os sinais e sintomas do hipotiroidismo são inespecíficos e facilmente confundíveis com queixas frequentes na gravidez como aumento de peso, falta de força, cansaço e obstipação. Pode haver, ainda, um aumento do volume da glândula tiroideia, conhecido por bócio.
Por outro lado, o hipertiroidismo é caracterizado pelo excesso de hormonas tiroideias maternas, que sendo uma condição mais rara que a anterior pode, contudo, atingir até 1% das grávidas.
Os sintomas do hipertiroidismo relacionam-se com o aumento da incidência de aborto, parto prematuro, pré-eclampsia, insuficiência cardíaca na grávida e no feto e morte intrauterina.
A clínica apresentada pela grávida também é inespecífica, confundindo-se com queixas frequentes na gravidez como vómitos, emagrecimento, taquicardia e intolerância ao calor.
O diagnóstico é geralmente feito da mesma forma na mulher grávida e não grávida incluindo o doseamento das hormonas tiroideias no sangue e o exame ecográfico da tiroide, que por ser um exame isento de radiação não tem qualquer efeito nocivo para o feto.
During pregnancy there are physiological changes in the body of the pregnant woman that force the thyroid gland to increase effort. Until about 20 weeks of gestation, the fetal thyroid does not synthesize hormones necessary for the development of the fetus so it needs the thyroid hormones produced by the mother. Thyroid hormones are essential for the development of the fetal central nervous system. Such a deficit can later translate into a child's cognitive delay or learning difficulties. The most frequent diseases resulting from changes in hormone production are hypothyroidism, which is characterized by maternal deficiency of thyroid hormones, which can affect more than 3% of pregnancies. The signs and symptoms of hypothyroidism are nonspecific and easily confused with frequent complaints in pregnancy, such as weight gain, lack of strength, tiredness and constipation. There may also be an increase in the volume of the thyroid gland, known as goiter. On the other hand, hyperthyroidism is characterized by maternal excess of thyroid hormones, it is a rarer condition than the previous one, but it can affect up to 1% of pregnant women. The symptoms of hyperthyroidism are related to the increased incidence of abortion, premature birth, pre-eclampsia, heart failure in pregnant women and the fetus and intrauterine death. The clinic presented by the pregnant woman is also nonspecific, being confused with frequent complaints in pregnancy such as vomiting, weight loss, tachycardia and heat intolerance. The diagnosis is usually made in the same way that it is made outside of pregnancy. Generally, thyroid hormones are measured in the blood and an ultrasound scan of the thyroid, which, being a radiation-free test, has no harmful effect on the fetus.
During pregnancy there are physiological changes in the body of the pregnant woman that force the thyroid gland to increase effort. Until about 20 weeks of gestation, the fetal thyroid does not synthesize hormones necessary for the development of the fetus so it needs the thyroid hormones produced by the mother. Thyroid hormones are essential for the development of the fetal central nervous system. Such a deficit can later translate into a child's cognitive delay or learning difficulties. The most frequent diseases resulting from changes in hormone production are hypothyroidism, which is characterized by maternal deficiency of thyroid hormones, which can affect more than 3% of pregnancies. The signs and symptoms of hypothyroidism are nonspecific and easily confused with frequent complaints in pregnancy, such as weight gain, lack of strength, tiredness and constipation. There may also be an increase in the volume of the thyroid gland, known as goiter. On the other hand, hyperthyroidism is characterized by maternal excess of thyroid hormones, it is a rarer condition than the previous one, but it can affect up to 1% of pregnant women. The symptoms of hyperthyroidism are related to the increased incidence of abortion, premature birth, pre-eclampsia, heart failure in pregnant women and the fetus and intrauterine death. The clinic presented by the pregnant woman is also nonspecific, being confused with frequent complaints in pregnancy such as vomiting, weight loss, tachycardia and heat intolerance. The diagnosis is usually made in the same way that it is made outside of pregnancy. Generally, thyroid hormones are measured in the blood and an ultrasound scan of the thyroid, which, being a radiation-free test, has no harmful effect on the fetus.
Descrição
Tese de mestrado, Análises Clínicas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Tiroide Gravidez Hipertiroidismo Hipotiroidismo Doença de Graves Tiroidite de Hashimoto Teses de mestrado -2021