妊娠中の内分泌疾患の管理
妊娠中の内分泌疾患の管理を行う際には，妊娠による母体のダイナミックな生理的変化を理解し，疾患が妊娠に与える影響，妊娠中の薬物療法や疾患の胎児への影響等を周知することが重要となる．特に，内分泌系の検査値は，妊娠によって大きな修飾を受けることから，その解釈が難しいことが多い．妊娠中の主な内分泌系の変化を解説し，主な内分泌疾患として，Basedow病，甲状腺機能低下症，下垂体腫瘍ならびに副腎腫瘍についての管理概要を述べた．...
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| Published in | 日本内科学会雑誌 Vol. 106; no. 11; pp. 2432 - 2438 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.11.2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.106.2432 |
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| Abstract | 妊娠中の内分泌疾患の管理を行う際には，妊娠による母体のダイナミックな生理的変化を理解し，疾患が妊娠に与える影響，妊娠中の薬物療法や疾患の胎児への影響等を周知することが重要となる．特に，内分泌系の検査値は，妊娠によって大きな修飾を受けることから，その解釈が難しいことが多い．妊娠中の主な内分泌系の変化を解説し，主な内分泌疾患として，Basedow病，甲状腺機能低下症，下垂体腫瘍ならびに副腎腫瘍についての管理概要を述べた． |
|---|---|
| AbstractList | 妊娠中の内分泌疾患の管理を行う際には，妊娠による母体のダイナミックな生理的変化を理解し，疾患が妊娠に与える影響，妊娠中の薬物療法や疾患の胎児への影響等を周知することが重要となる．特に，内分泌系の検査値は，妊娠によって大きな修飾を受けることから，その解釈が難しいことが多い．妊娠中の主な内分泌系の変化を解説し，主な内分泌疾患として，Basedow病，甲状腺機能低下症，下垂体腫瘍ならびに副腎腫瘍についての管理概要を述べた． |
| Author | 荒田, 尚子 |
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| Copyright | 2017 一般社団法人 日本内科学会 |
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| DOI | 10.2169/naika.106.2432 |
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| References | 12) Almalki MH, et al: Managing prolactinomas during pregnancy. Front Endocrinol (Lausanne) 6: 85, 2015. 9) Laurberg P and Andersen SL: Therapy of endocrine disease: antithyroid drug use in early pregnancy and birth defects: time windows of relative safety and high risk? Euro J Endocrinol 171: R13-20, 2014. 10) Momotani N, et al: Effects of iodine on thyroid status of fetus versus mother in treatment of Graves' disease complicated by pregnancy. J Clin Endocrinol Metab 75: 738-744, 1992. 14) 上田 建, 他: 妊娠合併Cushing症候群に対し副腎摘除術後満期正常分娩に至った1例. 日泌会誌 89: 678-681, 1998. 2) Tyson JE, et al: Studies of prolactin secretion in human pregnancy. Am J Obstet Gynecol 113: 14-20, 1972. 7) 荒田尚子: 抗甲状腺薬に関するPOEMスタディの概要. 日本臨床 70: 1976-1982, 2012. 5) Alexander EK, et al: 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27: 315-389, 2017. 8) Yoshihara A, et al: Treatment of Graves' disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation. J Clin Endocrinol Metab 97: 2396-2403, 2012. 3) Laway BA, Mir SA: Pregnancy and pituitary disorders: challenges in diagnosis and management. Indian J Endocrinol Metab 17: 996-1004, 2013. 16) Petraglia F and D'Antona D: Maternal endocrine and metabolic adaptation to pregnancy, update.com (last updated: May 31, 2016). 6) 荒田尚子: 妊娠中の甲状腺機能亢進症の管理とその問題点. 医学のあゆみ 260: 749-753, 2017. 11) Momotani N, et al: Power of TSAb/TBII in diagnosing fetal thyrotoxicosis and predicting neonatal hyperthyroidism. Thyroid 17 (S1): S-66, 2007. 13) Laway BA: Pregnancy in acromegaly. Ther Adv Endocrinol Metab 6: 267-272, 2015. 1) Foyouzi N, et al: Pituitary gland and pregnancy. Obstet Gynecol Clin North Am 31: 873-892, xi, 2004. 4) Burrow GN, et al: Maternal and fetal thyroid function. N Engl J Med 331: 1072-1078, 1994. 15) Chapter 21 Endocrine Changes in Pregnancy; Chapter 12 Hyperthyroid disorders. Williams Textbook of Endocrinology, the 13th edition, Elsevier, 2015, 832-848; 395-415. |
| References_xml | – reference: 1) Foyouzi N, et al: Pituitary gland and pregnancy. Obstet Gynecol Clin North Am 31: 873-892, xi, 2004. – reference: 6) 荒田尚子: 妊娠中の甲状腺機能亢進症の管理とその問題点. 医学のあゆみ 260: 749-753, 2017. – reference: 16) Petraglia F and D'Antona D: Maternal endocrine and metabolic adaptation to pregnancy, update.com (last updated: May 31, 2016). – reference: 11) Momotani N, et al: Power of TSAb/TBII in diagnosing fetal thyrotoxicosis and predicting neonatal hyperthyroidism. Thyroid 17 (S1): S-66, 2007. – reference: 9) Laurberg P and Andersen SL: Therapy of endocrine disease: antithyroid drug use in early pregnancy and birth defects: time windows of relative safety and high risk? Euro J Endocrinol 171: R13-20, 2014. – reference: 8) Yoshihara A, et al: Treatment of Graves' disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation. J Clin Endocrinol Metab 97: 2396-2403, 2012. – reference: 13) Laway BA: Pregnancy in acromegaly. Ther Adv Endocrinol Metab 6: 267-272, 2015. – reference: 3) Laway BA, Mir SA: Pregnancy and pituitary disorders: challenges in diagnosis and management. Indian J Endocrinol Metab 17: 996-1004, 2013. – reference: 4) Burrow GN, et al: Maternal and fetal thyroid function. N Engl J Med 331: 1072-1078, 1994. – reference: 2) Tyson JE, et al: Studies of prolactin secretion in human pregnancy. Am J Obstet Gynecol 113: 14-20, 1972. – reference: 10) Momotani N, et al: Effects of iodine on thyroid status of fetus versus mother in treatment of Graves' disease complicated by pregnancy. J Clin Endocrinol Metab 75: 738-744, 1992. – reference: 15) Chapter 21 Endocrine Changes in Pregnancy; Chapter 12 Hyperthyroid disorders. Williams Textbook of Endocrinology, the 13th edition, Elsevier, 2015, 832-848; 395-415. – reference: 7) 荒田尚子: 抗甲状腺薬に関するPOEMスタディの概要. 日本臨床 70: 1976-1982, 2012. – reference: 5) Alexander EK, et al: 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27: 315-389, 2017. – reference: 12) Almalki MH, et al: Managing prolactinomas during pregnancy. Front Endocrinol (Lausanne) 6: 85, 2015. – reference: 14) 上田 建, 他: 妊娠合併Cushing症候群に対し副腎摘除術後満期正常分娩に至った1例. 日泌会誌 89: 678-681, 1998. |
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| Title | 妊娠中の内分泌疾患の管理 |
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