Мать и дитя в Кузбассе (Feb 2023)
EVALUATION OF ULTRASOUND SCREENING FOR THYROID DISEASES IN WOMEN OF FERTILE AGE IN THE PRECONFIDENTIAL STAGE AND IN THE FIRST TRIMESTER OF PREGNANCY
Abstract
Objective – to evaluate the effectiveness of ultrasound screening of thyroid diseases in women of fertile age at the pre-pregnancy stage and in the first trimester of pregnancy. Materials. 1670 ultrasound examinations of the thyroid gland were performed, including 1532 in non-pregnant women (at the pre-pregnancy stage) and 138 studies in pregnant women in the 1st trimester. The women were divided into groups: A1 (n = 182) – women with revealed structural changes in the thyroid gland at the pre–pregnancy stage, B1 (n = 32) – comparison group (without changes in the thyroid gland), A2 (n = 124) – women with revealed structural changes in the thyroid gland during gestation, B2 (n = 14) – a comparison group of pregnant women (without changes in the thyroid gland). Results. Diffuse changes in the thyroid gland at the pregravidar stage were detected in 11.9 % of women. The revealed changes in the structure of the gland are characterized by the accentuation of contours and increased blood flow in the parenchyma, which statistically significantly correlated with an increased content of TSH in the blood. Diffuse changes were noted in 30.4 % pregnant women. A reliable sign of subclinical hypothyroidism (with an increase in TSH) is only an increased emphasis on the contours of the thyroid lobes during echographic scanning. Conclusion. The most effective and accurate in the diagnosis of thyroid pathology is a combination of ultrasound and determination of TSH in blood plasma. Echographic examination of the thyroid gland with the determination of TSH in blood plasma should be included in the examination program of patients at the pre-gravidar stage.
