| Objective: The hypothalamus-pituitary-thyroid axis system during pregnancy is in a special status of stress,hypothalamus-pituitary-adrenal axis is after expression as well as the thyroid function. Thyroid itself has specific change:Pregnant fit nourish cells secrete HCG which stimulated thyroid, with result of maintaining the level of thyroid hormone 25% ~ 30% higher than not pregnancy . THS reduced in the first trimester pregnancy by the influence of HCG;The level of TBG is higher with 2 ~ 3 times than not pregnancy;The level of TT4 is higher with 1.5 times than not pregnancy,which provided sufficient iodine pool for early fetal nerous system development;During pregnancy, The biological activity of T3 is 20%. The biological activity of T4 is high to 80%. So T4 is is an important index of the thyroid function and much more important during pregnancy .During mid-and late trimester pregnancy,FT4 is in the upper 1/3 levels of normal range women and declined slightly in late trimester pregnancy . The clinical hypothyroidism especially hypothyroidism pregnancy has unification of specific criteria for diagnosis. Evaluation of thyroid function is relying on laboratory testing and symptoms of patients to control the adverse incidence of pregnancy outcome.Hypertension disease is the clinic common disease.The recent and long-term complications serious harmed the pregnany and health of mather. There is no effective treatment by now. The internal relations between Hypothyroidism and Hypertension disease is little reported home and abroad. Thyroid hormone combinied with the liver cell nucleus receptors ,promoted the transcription and thus increased tissue protein synthesis and metabolism. Hypothyroidism will affect the liver protein synthesis further affect plasma protein function. Such as Plasma colloid osmotic pressure,Plasma PH value,Transportation function,The immune function,Catalysis,Nutritional role,coagulation and anticoagulant,the role of Fibrinolytic. Moreover the low level of thyroid hormone has an important impact on the cardiovascular system through the complex mechanisms. The author of this paper researched the comparison of the maternal thyroid fuction in late trimester pregnancy complicated hypertensive disease to explore internal relations between them. Provide a new idea of prevention to hypertensive disease.This paper retrospectively expounded hypothyroidism in late trimester pregnancy complicated hypertensive with thyroid function indexes and plasma protein level, perinatal outcomes, obstetrics complications, etc. To study the negative effects of Thyroid function abnormality to the pregnancy outcome, plasma protein level and Pregnancy-induced hypertension disease.Methods: Retrospective analysis of Pregnant women diagnosed with single live tire 68 from 2009 to 2010 in the center of tianjin obstetrics and gynecology hospital. According to the TSH are divided into three groups, hyperthyroidism group of 4 cases, average age (34.50±7.93), Thyroid function normal group of 39 cases 0.3 0.05). ALB,Birth week,Neonatal score,the incidenc rate of bad ending and Birth weight were slightly lower than control group withnot statistically significant difference (p > 0.05). The Hypothyroidism group compared with the control group:TSH was significantly higher than control group,with the statistically significant differences (p < 0.05). FT4,TT3,TT4,ALB,TP,Birth week,Birth weight were significantly lower than control group,with the statistically significant differences (p < 0.05) . FT3 and Neonatal score were slightly lower than control group withnot statistically significant difference (p > 0.05). The incidenc rate of bad ending was slightly higher than control group withnot statistically significant difference (p > 0.05). Compare the level of thyroid hormone and plasma protein concentration of different groups of pregnancy hypertensive disease with TSH:①Pregnancy hypertension disease group compared with the control group:TSH,FT3 were slightly lower than the control group, but there was not statistically significant (p > 0.05);TT4,TT3,TP,ALB were slightly higher than the control group, but there was not statistically significant (p > 0.05).②Mild preeclampsia group compared with the control group:TSH,TT4,TT3,FT4,FT3 were slightly higher than the control group, but there was not statistically significant (p > 0.05);But TP was slightly lower than control group, without the statistically significant differences (p > 0.05). ALB was significantly lower than control group ,with the statistically significant differences (p < 0.05).③Severe preeclampsia group, compared with the control group:TSH was significantly higher than control group ,with the statistically significant differences (p < 0.05). TT4,TT3,FT3,ALB were significantly lower than control group , with the statistically significant differences (p < 0.05). FT4,Tp were slightly lower than control group, without the statistically significant differences (p > 0.05). Conclusion: There is relevance between pregnancy hypertensive disease and hypothyroidism .The same link of pregnancy hypertensive disease and hypothyroidism is the low level of albumin. The clinical manifestations and assay index of thyroid fuction are polymorphism in pregnancy ,which should establish individual identification diagnosis. |
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