Assuntos
Complicações na Gravidez/classificação , Licença Médica/classificação , Feminino , Seguimentos , Humanos , Seguro Saúde , Gravidez , SuéciaRESUMO
OBJECTIVE: To study the expression, distribution, and function of thyroid-stimulating hormone receptor (TSHR) and thyroid hormone receptors (TR) α1, α2, and ß1 in human endometrium. DESIGN: Experimental clinical study. SETTING: University hospital. PATIENT(S): 31 fertile women. INTERVENTION(S): Endometrial biopsy samples obtained throughout the menstrual cycle. MAIN OUTCOME MEASURE(S): Real-time reverse transcriptase polymerase chain reaction, immunohistochemistry and Western blot to study the expression of TSHR, TRα1, TRα2, and TRß1 messenger RNA (mRNA) and proteins in human endometrium. RESULT(S): We found TSHR, TRα1, TRα2 and TRß1 mRNA and proteins expressed in human endometrium. Immunostaining for TSHR in the luminal epithelium and TRα1 and ß1 in the glandular and luminal epithelium increased statistically significantly on luteinizing hormone (LH) days 6 to 9, coinciding with appearance of pinopodes. Endometrial stromal and Ishikawa cells expressed mRNA for TSHR, TR, and iodothyronine deiodinases 1-3. After 48 hours, TSH significantly increased leukemia inhibitory factor (LIF) and LIF receptor (LIFR) messenger RNA (mRNA) in endometrial stromal cells, but decreased their expression in Ishikawa cells. Glucose transporter 1 mRNA was up-regulated by TSH in Ishikawa cells. We found that TSH statistically significantly increased secretion of free triiodothyronine (T3) and total thyroxin (T4) by Ishikawa cells compared with nonstimulated cells. CONCLUSION(S): Thyroid hormones are directly involved in endometrial physiology.
Assuntos
Endométrio/fisiologia , Receptores da Tireotropina/genética , Receptores alfa dos Hormônios Tireóideos/genética , Receptores beta dos Hormônios Tireóideos/genética , Biópsia , Células Cultivadas , Meios de Cultivo Condicionados/farmacologia , Endométrio/citologia , Endométrio/ultraestrutura , Feminino , Expressão Gênica/fisiologia , Transportador de Glucose Tipo 1/genética , Humanos , Imuno-Histoquímica , Fator Inibidor de Leucemia/genética , Subunidade alfa de Receptor de Fator Inibidor de Leucemia/genética , Microscopia Eletrônica de Varredura , RNA Mensageiro/metabolismo , Receptores da Tireotropina/metabolismo , Proteína 1 Supressora da Sinalização de Citocina , Proteínas Supressoras da Sinalização de Citocina/genética , Receptores alfa dos Hormônios Tireóideos/metabolismo , Receptores beta dos Hormônios Tireóideos/metabolismoRESUMO
OBJECTIVE: To describe neonatal outcome including the presence of congenital malformations in infants born to women substituted with thyroid hormones, and the maternal characteristics of these women. DESIGN: Register study based on prospectively collected data in relation to delivery. SETTING: Swedish Health Registers. POPULATION: All pregnant women (n=848,468) and all infants born (n=861,989) in Sweden from 1 July 1995 to 31 December 2004. METHODS: Women who reported the use of thyroid hormones in early pregnancy or obtained a prescription for thyroid hormones later in pregnancy (n=9,866), as well as their infants (n=10,055) were identified from the Swedish Medical Birth Register. The reference population consisted of all women giving birth and their offspring during the same time interval. MAIN OUTCOME MEASURES: Neonatal outcome, malformations and maternal characteristics. Data were analyzed with adjustments for identified confounders. RESULTS: Women using thyroxine had an increased rate of pre-eclampsia, diabetes (pre-existing or gestational), cesarean sections and inductions of labour compared to women in the reference population. The risk for preterm birth was marginally increased (OR 1.13, 95% CI 1.03-1.25). Neonatal thyroid disease was found in eight infants (seven with thyreotoxicosis and one unspecified), the expected number was 0.2. No further anomalies in neonatal diagnoses were found. A small but statistically significant risk for congenital malformations (OR =1.14, 95% CI 1.05-1.26) was found. CONCLUSION: Women on thyroid substitution during pregnancy had an increased risk for some pregnancy complications, but their infants were only slightly affected.
Assuntos
Hipotireoidismo/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Hormônios Tireóideos/efeitos adversos , Adulto , Anormalidades Congênitas/etiologia , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/etiologia , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/etiologia , Resultado da Gravidez , Sistema de Registros , Hormônios Tireóideos/uso terapêuticoRESUMO
Jaundice in early pregnancy after in vitro fertilization (IVF) is extremely rare. We report a case of severe jaundice in an IVF treated patient, with a clinical picture similar to intrahepatic cholestasis of pregnancy (ICP). We suggest strategies to prevent similar cases in the future.
