Successful in utero treatment of fetal goitrous hypothyroidism: case report and review of the literature.
In this report, we present a case of fetal goiter with overdistended fetal neck and mild polyhydramnios. Amniocentesis and cordocentesis were conducted at 32 weeks' gestation and fetal goitrous hypothyroidism was diagnosed. Intra-amniotic injection of l-thyroxine (T4) was performed with a weekly dose of 150 microg four times between 33 and 36 weeks' gestation. In response to this in utero treatment, the goiter was reduced and polyhydramnios was improved. The mother gave birth to a healthy live male infant with normal thyroid function. From our case report and review of previous literature, we recommend that the amount of l-thyroxine start as low as 150 microg, and that repeat cordocentesis be avoided as long as other clinical and laboratory parameters indicate improvement of the fetal conditions.
Hashimoto
H
H
Department of Obstetrics, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. jolly@pc4.so-net.ne.jp
Hashimoto
K
K
Suehara
N
N
D000328:Adult; D017218:Cordocentesis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D006042:Goiter / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000188:drug therapy*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D013974:Thyroxine / Q000627:therapeutic use*
D013974:Thyroxine