释 义 n. [药] 丙基硫氧嘧啶；[药] 丙硫氧嘧啶
例 句 No such cases have been reported with propylthiouracil use during pregnancy.若妊娠期使用的是丙硫氧嘧啶，则不会出现上述情况。
作者： Kristen Kobaly
期刊：Endocrinol Metab Clin N Am
Women with gestational thyrotoxicosis generally require no treatment. Antithyroid drugs (ATDs) are not recommended because of the transient nature of the abnormalities, risk of maternal/fetal hypothyroidism, and concern for teratogenicity. Thyroid function tests should be followed periodically through resolution of the abnormalities with monitoring for a hypothyroid phase if there is suspicion for transient autoimmune thyroiditis as an alternate diagnosis. b-Blockers may be considered; details of the use of these drugs in pregnancy is discussed further later. Hyperemesis gravidarum requires supportive care, including antiemetics, intravenous fluids, and correction of electrolytes abnormalities, if severe. GRAVES’ DISEASE IN PREGNANCY Graves’ disease may present for the first time during pregnancy or postpartum. A recent population-based cohort study using the Danish nationwide registry found the incidence ratio of hyperthyroidism to be high in the first 3 months of pregnancy, very low in the last 3 months, and highest at 7 to 9 months postpartum. For women with known Graves’ disease, exacerbation or relapse may occur by 10 to 15 weeks gestation. In the late second or third trimester, a period of immune tolerance, patients often enter remission, a process that correlates with decreases in TRAb levels. Disease may relapse postpartum as TRAb levels increase, with the greatest risk occurring around 7 to 9 months following delivery. There is a 2- fold to 4-fold increased risk of new-onset Graves’ disease in the postpartum period.PRECONCEPTION THERAPY FOR WOMEN WITH PREEXISTING GRAVES’ DISEASE In women with Graves’ disease interested in childbearing, therapeutic considerations include the time course of planned conception, disease history and activity, and TRAb levels. A discussion of the risk of birth defects from ATDs should occur. If ATDs are continued, women may either be treated with propylthiouracil (PTU) before conceiving or changed to PTU as soon a pregnancy is confirmed. Definitive treatment is often preferable unless disease course is mild or pregnancy is imminent. Hyperthyroidism should be controlled for several months before attempting pregnancy, and, if radioactive iodine or surgery are used, hypothyroidism should be treated with levothyroxine to achieve a euthyroid state before trying to conceive. Pregnancy should be avoided for 6 months following radioactive iodine.