Official websites use. Share sensitive information only on official, secure websites. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and Having Sex With A Pregnant Lady assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period. Keywords: Congenital, hypothyroidism, thyroid diseases, maternal thyroid problems, newborn. Fetus ve yenidoğanda tiroid fonksiyonları bebek sağlığı ve merkezi sinir sisteminin gelişimi açısından önem taşımaktadır. Doğumdan hemen sonra da bu etkilerin yansımaları görülür. Gebelikte annenin tiroid hastalıkları açısından incelenmesi gereken hallerin tanınması ve sağlıklı değerlendirilmesi, tüm yenidoğanların yaşamın ilk günlerinde konjenital hipotiroidi için taranması, tarama sonuçlarının zamanında ve sağlıklı değerlendirilmesi, Having Sex With A Pregnant Lady hipotiroidili olguların erken tanısı, erken ve yeterli tedavisi, geçici tiroid hormon bozukluklarının değerlendirilmesi ve yönetimi, hipotiroidi tanısı ile tedavi başlanan hastaların tiroid fonksiyon ve gelişimlerinin yaşamın ilk yıllarında yakın izlemi bu dönemde tiroid fonksiyon bozuklukları ya da hipotiroidisi olan bebeklerin gelişimsel sonuçları açısından son derece önemlidir. Bu kılavuz çocuk hekimleri, yenidoğan ve çocuk endokrinoloji uzmanlarına gebelik ve yenidoğan döneminde fetus ve bebeği ilgilendiren tiroid fonksiyon bozuklukları ve tiroid hastalıklarının değerlendirilmesi, tanısı ve yönetimi konusunda yol göstermek amacıyla kaleme alınmıştır. In the gestation period, daily iodine intake should be increased to mcg in order to meet the requirements of both the mother and the fetus. Increased placental human chorionic gonadotropin hCG stimulates the thyroid gland like thyrotropin thyroid-stimulating hormone-TSH. In addition, placental estrogen provides an increase in triiodothyronine T3 and thyroxine T4 levels by prolonging the half-life of thyroxine-binding globulin TBG. Detection of T4 in coelomic fluid indicates that maternal support to the fetus starts in the early gestational weeks. The fetal thyroid gland starts to uptake iodine and synthesize T4 in the 10 th week. Thyroid hormone support from the mother continues until the 20 th gestational week, and thereafter, T3, T4 synthesis, and an increase in TSH continue incrementally. If dyshormogenesis or agenesis is present in the fetus, maternal support prolonges until birth. The fetal thyrotropin- releasing hormone TRH pool initially derives from the placenta and fetal pancreas. In the 34 th gestational week, fetal hypothalamus-derived TRH synthesis matures. The ability to overcome the Wolff-Chaikoff phenomenon, which consists of iodine loading, matures after the 34 th week. Maternal support is interrupted and neonatal thyroid functions start with delivery. A physiologic hyperthyroxinemia period is experienced in the postnatal days and this contributes to metabolic adaptation 1 - 2. Thyroid function tests of pregnancy for Turkish population are shown Table 1 3. Thyroid functions are evaluated by trimeters in the gestation period Table 2 1. TSH values by trimesters 1 However, there are studies indicating that the thyroglobulin level is not a reliable variable as an evaluation criterion for iodine deficiency. If the thyroid volume is above 18 mL in pregnancy, it is considered a criterion for goitre; if it is above 22 mL, it is definite that goitre is present 4. Iodine deficiency : Iodine deficiency present in the prenatal period or that occurs during pregnancy has a series of negative effects in the mother, fetus, newborn or in later periods of life Table 3 4. Salt restriction during pregnancy because of hypertension or preeclampsia and eclampsia lead to iodine deficency. Maternal smoking increases thiocyanate levels and this decreases iodine levels in both urine and breastmilk. The period between the 13 Having Sex With A Pregnant Lady and 19 th gestational weeks during which the brain T3 receptors increase, is known as the critical period in terms of the fetus 4. Maternal, fetal, neonatal and long-term effects of iodine deficiency 4. An increase in thyroglobulin levels may be observed, but it may not always be reliable in terms of indicating iodine deficiency in gestation 9. Thyroid functions should be checked starting from the 12 nd gestational week 4. Treatment : Women should have a daily iodine intake of at least µg.
Oral iodine tablets , µg tablets or one drop of lugol solution per month can be given to pregnant women for whom iodized salt intake has been limited. Forumları Okundu Kabul Et. Maternal hyperthyroidsm : Maternal hyperthyroidism is observed in 0. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period. Google Çeviri Hakkında. Doküman çevirisi İngilizce.
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