Ukulungiswa kweDose Kungase Kudingeke Ukuqinisekisa Impilo Yomntwana We-Fetal
Ingubo yakho ye-thyroid ibalulekile ngesikhathi ukhulelwe njengoba ilawula ukukhiqizwa kwe-hormone okuthiwa i-triiodothyronine (T3) ne-thyroxine (T4), ngayinye edlala indima ebalulekile ekuthuthukiseni ubuchopho bomntwana nesistimu yezinzwa.
Phakathi ne-trimester yokuqala, i-fetus ixhomeke ekuhlinzekeni komama we-hormone ye-thyroid, ehlinzeka nge-placenta.
Ukuze uhlangabezane nalesi sidingo, ukukhiqizwa kwekhanda lomama kuzoba ngokweqile, okuholela ekutheni ukwandisa umgogodla uqobo. Lokhu kuvame ukuphawula futhi ngeke kube nzima ukukhulelwa nganoma iyiphi indlela.
Kodwa-ke, kwezinye izimo, ukwandiswa kungahle kubonakale ekuhlolweni komtholampilo futhi kusikisela ukuthi owesifazane une- hypothyroidism , isimo lapho igciwane le-thyroid lingakhiqiza i-hormone ye-thyroid eyanele.
Izinguquko kumsebenzi we-Thyroid ngesikhathi sokukhulelwa
Ngisho ngaphansi kwezimo ezivamile, ukukhulelwa kubeka ukucindezeleka kwi-gland yegciwane. Isidingo sokwandisa ukukhiqizwa kwe-hormone ngamaphesenti angaba ngu-50 ngokujwayelekile kuzoholela ekwandiseni umgqo ngokwawo. Kulabo besifazane abanomsebenzi ovamile we-thyroid, i-gland inganda ngamaphesenti angu-10 ngosayizi. Kulabo besifazane abane-hypothyroidism, kungase kwande ngamaphi amaphesenti angu-20 kuya ku-40.
Ngaphandle kokukhuliswa komzimba ngokwayo, kunezinguquko ekukhiqizeni i-hormone odokotela abangakwazi ukuqapha ukusebenzisa ukuhlolwa kwegazi.
Omkhulu phakathi kwabo yisilingo se- TSH , esilinganisa izinga le-hormone ye-thyroid-stimulating (TSH) egazini. I-TSH yi-hormone eyenziwa yi-pituitary gland edala ukukhiqizwa kwe-T3 no-T4.
Ngenxa yokuthi umsebenzi ovamile we-thyroid uhlukile ngesikhathi sokukhulelwa, amanani we-TSH azoshintsha njengoba umama ethuthuka kusukela kokuqala kuya kwesithathu.
Ngaphansi kwezimo ezivamile, inani elijwayelekile le-TSH lizoqala kusuka ku-0.2 kuya ku-4.0 mlU / L.
Uma nganoma yisiphi isizathu i-gland yegciwane ayikwazi ukuqhubeka ngesikhathi sokukhulelwa, inani lizokwehla, okubonisa isimo se-hypothyroid. Uma kunjalo, imithi yokwelapha i-hormone ye-hormone iyobekwa ukuba ithathe indawo ye-hormone ye-thyroid engekho. Umama uzobe ehlolwe njalo ukuhlola amanani we-TSH, ukulungisa ukwelashwa njengoba kudingeka.
Ukuqapha i-TSH ngesikhathi sokukhulelwa
Ama-laboratories amaningi akha izilinganiso zabo eziqondene nalokho okubhekwa yi-TSH ezichaza ukuthi yiziphi izinto ezizibheka njengamazinga "evamile" ngesikhathi ngasinye sokukhulelwa. Uma kungenjalo, i-American Thyroid Association (ATA) incoma ukusetshenziswa kwezigaba ezilandelayo:
- I-trimester yokuqala: 0.1-2.5 mIU / L
- I-trimester yesibili: 0.2-3.0 mIU / L
- I-trimestre yesithathu: 0.3-3.0 mIU / L
Uma unesifo se- thyroid, kufanele uhlolwe njalo phakathi nokukhulelwa kwakho konke . Uma isifo se-thyroid sisebenza emndenini wakho noma unezibonakaliso zesifo, kubalulekile ukwazisa udokotela wakho ukuze ukwazi ukuqapha ngokucophelela futhi uphathwe kahle.
I-Hypothyroidism
Uma u-hypothyroid, kubalulekile ukuthi uphathwe kokubili ngaphambi nangesikhathi sokukhulelwa kwakho. Uma kushiywe kungalashwa noma kungaphathwa kahle, i-hypothyroidism yakho ingabangela ingane yakho ukuthuthuka nezinkinga.
Uma uphathwa nge-hypothyroidism, ungacabangi ukuthi ungaqhubeka nokulawula isimo sakho ngendlela efanayo. Eqinisweni, kungase kudingeke ukwandise umthamo wakho wezidakamizwa ze-hormone esikhundleni se- thyroid okungenani ngamaphesenti angu-50 ngokushesha nje lapho ukhulelwe kuqinisekiswa. Eqinisweni, ucwaningo lubonisa ukuthi amaphesenti angu-50 kuya kwangu-80 abesifazane besifo se-hypothyroid kuzodingeka benze lokhu.
Ngokusho kwemihlahlandlela ye-ATA, lokhu kwanda kufanele kuqale masonto onke 4 ukuya ku-6 futhi uqhubeke kuze kube amasonto 16 ukuya ku-20 (emva kwalokho umsebenzi wakho wegciwane uzobe usubeka phansi kuze kube sekulethwa kwezidingo).
Mayelana nokuqapha, ukuhlolwa kwe-thyroid kuzodingeka kuqhutshwe njalo ngemva kwamasonto amane phakathi nengxenye yokuqala yokukhulelwa bese kuphinda phakathi kwamasonto 26 no-32.
Ukulandela ukulethwa kwezidingo, imithi yokwelapha izodinga ukunciphisa amazinga angaphambi kokukhulelwa ngokuqapha okulandelwayo kwenziwa amasonto ayisithupha emva kosuku lokubeletha.
Izifo zikaHashimoto
Isifo sikaHashimoto , esaziwa nangokuthi i-Hashimoto's thyroiditis, yisifo esizimele esihlasela futhi kancane kancane sibhubhise igciwane le-thyroid. I-Hypothyroidism ivame ukuphumela kweso sifo futhi iphathwe ngendlela efanayo ngokusebenzisa i-hormone replacement therapy.
Ukwelashwa kwesifo sikaHashimoto ngesikhathi sokukhulelwa kuhilela ukwelapha i-hypothyroidism, nakuba kufanele kwenziwe ukunakekelwa okungaphezulu kokugcina i-TSH ngaphansi kwe-2.5 mlU / L, njengoba amazinga aphakeme ahlotshaniswa nokukhuphuka kabili engozini yokukhulelwa kwesisu.
Izifo zamathuna
Kwezinye izimo, owesifazane angase abe nokusebenza ngokweqile kune-thyroid engasebenzi. Lokhu kwaziwa ngokuthi hyperthyroidism, okuvame ukubangelwa yisifo se-Graves .
Uma ishiywe ingalashwa, i-hyperthyroidism ingaholela ekubelethweni ngaphambi kwesikhathi noma ngaphambi kwe-preeclampsia (ukucindezeleka kokukhulelwa okubhekene nomfutho wegazi ophezulu nokulimala komzimba). Izingozi kumntwana zihlanganisa isisindo sokuzalwa esincane, isilinganiso senhliziyo esisheshayo, amaphutha okuzalwa, kanye nezinye izinto eziphathelene nokuphila. Ezimweni ezimbi kakhulu, ukubeletha kungenzeka.
Ukwengeza, uma ukhulelwe futhi unesifo se-Graves, usengozini enkulu yokwenza uhlobo olubi lwe-hyperthyroidism ebizwa ngokuthi isiphepho se-thyroid . Eyaziwa nangokuthi inkinga ye-thyrotoxic, ibangelwa ukukhululwa okwedlulele kwamahomoni wegciwane okwenza ukwanda okungase kube yingozi ekucindezelweni kwegazi, izinga lokushisa komzimba, nokushaya kwenhliziyo.
Ngesikhathi sokukhulelwa, izifo ze-Graves ngokuvamile ziphathwa ngemithi e-antithyroid ebizwa ngokuthi i-propylthiouracil ngesikhathi se-trimester yokuqala nenye ebizwa ngokuthi i-methimazole isikhathi esisele sokukhulelwa.
Izwi elivela
Into ebalulekile okumele uyikhumbule ukuthi uma u-hypothyroid futhi uhlela ukukhulelwa, udinga ukukhuluma nodokotela wakho mayelana nokulungisa umthamo wakho wemithi ye-hormone esikhundleni sokuthi ukhiqize ukuzala. Umgomo ukugcina izinga lakho le-TSH ngaphansi kwe-2.5 mIU / L.
Kufanele futhi usebenze nodokotela wakho ukuze uqinisekise ukukhulelwa kwakho ngangokunokwenzeka, futhi ube necebo endaweni ukuze ukwandise umthamo wakho wemithi ngesilinganiso esinqunyiwe ngokushesha uma ukhulelwe ukuqinisekiswa.
> Umthombo:
> Alexander, E ,; I-Pearce, E .; I-Brent, G .; et. al. "I-2017 Imihlahlandlela ye-American Thyroid Association yokuHlola nokuPhathwa kwezifo ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum." I- Thyroid. 2017; 27 (3): 315-389.