title: Antenatal diagnosis and treatment of fetal hypothyroidism. A report of two cases.
abstract: Fetal goiter in the presence of maternal Graves' disease can signify either hyperthyroidism or hypothyroidism in the fetus. Two patients with Graves' disease taking propylthiouracil were found to have a fetal goiter on a prenatal sonogram. Fetal blood sampling identified hypothyroidism in both instances. Administration of intraamniotic thyroxine resulted in rapid resolution of the goiter, normalization of subsequent fetal thyroid studies, and delivery of a euthyroid fetus. Cordocentesis allows accurate diagnosis and follow-up of fetal thyroid dysfunction and prompt initiation of appropriate therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tenn. 37232-2519, USA. joe.bruner@mcmail.vanderbilt.edu
authors.forename: J P
authors.initials: JP
authors.lastname: Bruner
authors.forename: E H
authors.initials: EH
authors.lastname: Dellinger
mesh_terms: D000328:Adult; D000650:Amnion; D000653:Amniotic Fluid / Q000737:chemistry; D017218:Cordocentesis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D005865:Gestational Age; D006042:Goiter / Q000000981:diagnostic imaging; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications; D011296:Prenatal Diagnosis; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000196:embryology; D013963:Thyroid Hormones / Q000032:analysis / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use; D016216:Ultrasonography, Prenatal
chemical_list: D013963:Thyroid Hormones; D011441:Propylthiouracil; D013974:Thyroxine