Hipotiroidismo Embarazo

7/26/2019 Hipotiroidismo Embarazo

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HIPOTIROIDISMEN EL

EMBARAZOINTERNADO DE GINECOLOGIA Y OBSTETRICIA

MEDICINA USS 2016


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DEFINICION

Patologa !o"o#a$a o! la $%&'%()#%*( $+ la& ,o!'o(a& t%!$+ &)& +.+#to& a (%"+l t%&)la!

P)+$+ $+/+!&+ a #)al)%+! alt+!a#%*( a (%"+l $+l ++ %ota%*4&%&3T%!o%$+& #la&%4#5($o&+ +(

Hipotiroidismo primario Alt+!a#%*( $+ la gl5($)la t%!o%$+

$+ to$o& lo& #a&o& Hipotiroidismo secundario Alt+!a#%*( ,%o4&%a!%a o

,%otal5'%#a ;,%ot%!o%$%&'o #+(t!al


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EPIDEMIOLOGIA

E(.+!'+$a$ !+"al+(t+ - $+ g!a( %'a#to +( la &al)$ o/la

E( C,%l+ #+!#a $+ )( 2 a )( =76: +( la o/la#%*( g+(+!al

10 "+#+& 'a& .!+#)+(t+ +( ')+!+&

I(#%$+(#%a a)'+(ta $%!+#ta'+(t+ #o( la +$a$ >1: +( ? 69

En embarazadas se!n MINSAL"

07>:3079: +( .o!'a #l(%#a7

23>: +( .o!'a &)/#l(%#a7


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FISIOPATOLOGIA

A)to%(')(+Alt+!a#%*( +( la

l%/+!a#%*( $+,o!'o(a

D!oga&D4#%t

$+ -o$o

Po&t3 Ra$%a#%

*(+t+!(a


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SINTOMATOLOGIA

INESPECIFICA A&t+(%a

So'(ol+(#%a

E&t!+@%'%+(to

P%+l &+#a

P+lo !alo - )+/!a$%o

I(tol+!a(#%a al .!%o o !o(#a

A)'+(to $+ +&o


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EN LA PACIENTEEMBARAHADA


7/17

CAMBIOS FISIOPATOLOGICOS

E( +l +'/a!ao &+ !o$)#%!a a)'+(to $+l '+ta//a&al A)'+(to $+l ta'a@o t%!o%$+o ;,%+!la&%a

El a)'+(to $+ la a#t%"%$a$ t%!o%$+a (o!'al'+(t+ #o'+(&a$o a)'+(ta($o la glo/)l%(a t!a&o!ta$,o!'o(a ;TBG


8/17

CAMBIOS FISIOPATOLOGICOS

La& ,o!'o(a& t%!o%$+a& &o( #!)#%al+& a!a +l $+&a!!ollo $+l

El t%!o%$+& .+tal #o'%+(a a .)(#%o(al $+&$+ la &+'a(a 1031al#a(a($o &) .)(#%o(a'%+(to (o!'al $+&$+ la &+'a(a >6

D)!a(t+ +l !%'+! t!%'+&t!+ la& ,o!'o(a& $+!%"a( +#l)&%"a$+ la 'a$!+


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COMPLICACIONES DEL EMBARA

#OMPLI#A#IONES MATERNAS A(+'%a

SIE A/o!to +&o(ta(+o D+&!+($%'%+(to $+ la#+(ta +'o!!ag%a o&t3a!to

D%&.)(#%*( t%!o%$+a o&t3a!to

#OMPLI#A#IONES $ETALES Mal.o!'a#%o(+& #o(g(%ta& Pa!to !+'at)!o - /ao +&o ;$+t+!'%(a$o o! TA 'at+!(a< D4#%t &%#o'oto! - (+)!o&%)%at!%#oJ

17 Stag(a!o3G!++( A C,+( K Bog$+( D +t al7 T,+ t,-!o%$ a($ !+g(a(#- a (o"+l !%& .a#to! .o! "+!- T,-!o%$ 2009 19>917

27 Ca&+- BM Da&,+ S +ll& CE +t al7 S)/#l%(%#al ,-ot,-!o%$%&' a($ !+g(a(#- o)t#o'+&7 O/&t+t G-

>7 B!+at,(a#, FM Do((+ll- Cool+- SM +t al7 S)/#l%(%#al ,-ot,-!o%$%&' a& a !%& .a#to! .o! la#+(tal .!o' a lo3!%& !%'%g!a"%$ o)lat%o(7 A)&t N H O/&t+t G-(a+#ol 201> 9>99>7


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DIAGNOSTICO

%+!%o

% &'( uI)*L &'( + &',uI)*L

S)B#LINI#O

&', + ,'-uI)*L

E)TIROIDIO

&'( + &',uI)*L

S)B#LINI#O

. (& uI)

R+" M+$ C,%l+ 20012 "ol 128

EMBARAZO :

- 2.5 en primer trimestre

- 3.0 en segundo y tercer trimestre


11/17

QSCREENING

No +%&t+ #o(&+(&o #la!oto$a"a

S+ /+(+4#%a!a( 'a& la&a#%+(t+& #o( .a#to!+& $+ !%+&go

Minsa/ recomienda tamiza0een toda pacienteembarazada

Dra. M. Soledad Hidalgo V.. (2013). Trastornos tiroideos en el embarazo. REV. MED. C!". C#"DES$ 2


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TRATAMIENTO

S)&t%t)#%*( ,o!'o(al #o( l+"ot%!o%(a ;S+a!a$o =,!& $+ la #o

EN HIPOTIROIDISMO PRE1IO AL EMBARAZO" A)&t+ $+ $o&%& !+#o ;63 &+' g+&ta#%*(


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S*bse+retaria de sal*d ,*bli+a. (2013). -*ia Clini+a /-E Hi,otiroidismo en ,ersona de 1& aos o ma


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CRITERIOS DE DERIACION AESPECIALIDAD



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BIBLIOGRAFIA

17 o& Lo'/a!$a P!%+to Ma!%&a F+!(5($+ P!+7 ;200VV=>


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2RA#IAS

Documents

Hipotiroidismo Embarazo