Successful treatment of recurrent non-immune hydrops secondary to fetal hyperthyroidism.
BACKGROUND
Non-immune fetal hydrops is a heterogeneous disorder with a mortality rate of 50-98%. Resolution of non-immune fetal hydrops is rare but has been reported to occur spontaneously or after targeted therapeutic measures.


METHODS
A euthyroid gravida with Graves disease presented with a history of three prior perinatal deaths between 26 and 28 weeks' gestation, all associated with fetal hydrops. In the current pregnancy, the fetus developed hydrops at 24 weeks' gestation. Fetal hyperthyroidism, with high-output cardiac failure, was diagnosed with fetal blood sampling. After maternal therapy with propylthiouracil, resolution of the non-immune hydrops were documented and a healthy neonate subsequently delivered to term. The neonate developed transient hyperthyroidism after delivery, which required treatment for 10 weeks.


CONCLUSIONS
Non-immune hydrops occurring as a result of fetal hyperthyroidism with high output cardiac failure is treatable with propylthiouracil.
Treadwell
M C
MC
Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, Michigan, USA.
Sherer
D M
DM
Sacks
A J
AJ
Ghezzi
F
F
Romero
R
R
D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D015160:Hydrops Fetalis / Q000188:drug therapy* / Q000209:etiology; D006980:Hyperthyroidism / Q000188:drug therapy* / Q000209:etiology; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011441:Propylthiouracil / Q000627:therapeutic use*; D012008:Recurrence
D013956:Antithyroid Agents; D011441:Propylthiouracil