medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-5-70-77medsovet-6794Research ArticleПРЕГРАВИДАРНАЯ ПОДГОТОВКА И БЕРЕМЕННОСТЬPREGRAVID PREPARATION AND PREGNANCYЙодный дефицит как причина гипотиреоза у беременных: диагностика и меры профилактикиIodine deficiency as a cause of hypothyroidosis in pregnant women: diagnostics and preventive measureshttps://orcid.org/0000-0002-7309-5974МедведеваМ. С.MedvedevaM. S.

Медведева Маргарита Сергеевна, студентка 5-го курса кафедры акушерства и гинекологии

295007, Республика Крым, Симферополь, пр-т Академика Вернадского, д. 4

Margarita S. Medvedeva, 5th Year Student of the Department of Obstetrics and Gynecology, Georgievskiy Medical Academy

47, Vernadskiy Ave., Simferopol, Republic of Crimea, 295007

margarita.ms@inbox.ruhttps://orcid.org/0000-0002-0284-7649ЛяшенкоА. С.LyashenkoA. S.

Ляшенко Анастасия Сергеевна, студентка 6-го курса кафедры акушерства и гинекологии

195067, Санкт-Петербург, Пискаревский пр-т, д. 47

Anastasiya S. Lyashenko, 6th Year Student of the Department of Obstetrics and Gynecology

47, Piskarevsky Ave., St Petersburg, 195067

grobovaya98@mail.ruhttps://orcid.org/0000-0002-4350-5020ЛяшенкоЕ. Н.LyashenkoE. N.

Ляшенко Елена Николаевна, к.м.н., доцент кафедры акушерства и гинекологии

295007, Республика Крым, Симферополь, пр-т Академика Вернадского, д. 4

Elena N. Lyashenko, Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology

4, Vernadskiy Ave., Simferopol, Republic of Crimea, 295007

helen.lyashen@mail.ruКрымский федеральный университет имени В.И. ВернадскогоРоссияVernadsky Crimean Federal UniversityRussian FederationСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation202220042022057077Copyright © Медведева М.С., Ляшенко А.С., Ляшенко Е.Н., 20222022Медведева М.С., Ляшенко А.С., Ляшенко Е.Н.Medvedeva M.S., Lyashenko A.S., Lyashenko E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6794

Беременность – период повышенных требований ко всем органам и системам организма матери, в том числе и к щитовидной железе (ЩЖ). Продуктивность ЩЖ в этот период увеличивается на 30–50%. Для непрерывного и достаточного синтеза гормонов ЩЖ необходимо оптимальное поступление в организм пищевого йода. Потребности в микроэлементе значительно возрастают во время беременности вследствие повышенной активности ЩЖ. Йодный дефицит легкой или умеренной степени приводит к недостаточному синтезу гормонов ЩЖ, несмотря на ее компенсаторное увеличение. Гипотиреоз у женщин является одной из причин бесплодия, а у беременных значительно повышает риск преждевременных родов. Йодная недостаточность оказывает серьезное влияние на внутриутробное развитие плода, ведь йод и тиреоидные гормоны принимают активное участие в  развитии плода, формировании различных органов и  развитии головного мозга. Для того чтобы предотвратить опасные последствия йодного дефицита, в Российской Федерации проводится массовая профилактика в виде применения йодированной соли. В I триместре беременности каждой женщине в качестве скрининга проводится лабораторное исследование уровня ТТГ, общего Т4 и общего Т3 для того, чтобы вовремя скорректировать гипофункцию ЩЖ. У беременных женщин, особенно в I триместре, потребности в йоде увеличиваются на 50%, что требует не только обязательного применения йодированной соли, но и назначения фармакологических препаратов йода с точной дозировкой. Профилактических мер может быть недостаточно, тогда применяется заместительная терапия левотироксином на протяжении всей беременности.

Pregnancy is a period of increased demands on all organs and systems of the mother’s body, including the thyroid gland (TG). The productivity of the thyroid gland increases by 30–50%. For continuous and sufficient synthesis of thyroid hormones (TG) requires optimal intake of dietary iodine. The need for a microelement increases significantly during pregnancy, due to increased activity of the thyroid gland. Iodine deficiency of mild or moderate degrees leads to insufficient synthesis of thyroid hormones, despite its compensatory increase. Hypothyroidism in women is one of the causes of infertility. Hypothyroidism in pregnant women significantly increases the risk of preterm birth. Iodine deficiency has a serious impact on the intrauterine development of the fetus, because iodine and thyroid hormones (TG) are actively involved in the development of the fetus, the formation of various organs and the development of the brain. In order to prevent the dangerous consequences of iodine deficiency in the Russian Federation, mass prevention is carried out in the form of the use of iodized salt. During the 1st trimester of pregnancy, each woman undergoes a laboratory test of the level of TSH, total T4 and total T3 as a screening in order to correct the hypofunction of the thyroid gland in  time. In pregnant women, especially in  the first trimester, iodine requirements increase by 50%, which requires not only the mandatory use of iodized salt, but also the appointment of pharmacological preparations of iodine with an accurate dosage. Preventive measures may not be enough, then replacement therapy with levothyroxine is used throughout the pregnancy.

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The authors declare that there are no conflicts of interest present.