PMID: 2486887Jan 1, 1989Paper

Fetal goitrous hypothyroidism. A new diagnostic and therapeutic approach

Fetal Therapy
R L JohnsonW H Clewell

Abstract

We present a first case in whom fetal hypothyroidism with goiter was both successfully diagnosed and treated in utero. An obstetrical sonogram at 33 weeks revealed a bilobed fetal neck mass, compatible with enlarged thyroid gland, associated with neck hyperextension, reduced gastric fluid, and polyhydramnios. Umbilical blood sampling after volume reduction amniocentesis confirmed fetal hypothyroidism with a euthyroid mother. Fetal T4 measured 1.3 micrograms/dl, free T4 0.3 ng/dl, and thyroid-stimulating hormone 186 microU. Intraamniotic levothyroxine, 500 micrograms, was given twice with a 14-day interval. The head flexed, gastric fluid increased, and amniotic fluid levels returned to normal. Prenatal (36 weeks) and neonatal blood sampling demonstrated return to euthyroid indices. Ultrasonic estimates of thyroid volume decreased by over 50%. Vaginal delivery at 39 weeks was uncomplicated. The newborn appeared normal and is being maintained on thyroid replacement therapy.

Citations

Feb 13, 2001·European Journal of Obstetrics, Gynecology, and Reproductive Biology·F PerrotinG Body
May 2, 2002·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·P AgrawalC Lees
Jan 13, 2006·Thyroid : Official Journal of the American Thyroid Association·Ali-Asghar Mirsaeid GhaziFereidoun Azizi
Nov 30, 2007·Fetal Diagnosis and Therapy·Pernille D LassenLillian Skibsted
Mar 24, 2009·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·C HuelD Luton

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