FETAL CORD-BLOOD SAMPLING IN THE DIAGNOSIS AND THE TREATMENT OF FETALHYPERTHYROIDISM IN THE OFFSPRINGS OF A EUTHYROID MOTHER, PRODUCING THYROID-STIMULATING IMMUNOGLOBULINS

We described here three individual pregnancies in a euthyroid mother w ith a past history of Graves disease and high levels of thyrotropin re ceptor stimulating antibodies. Ten years prior to her first pregnancy the mother underwent a partial thyroidectomy for Graves disease and re mained euthyroid since, but still produced high levels of thyrotropin receptor stimulating antibodies. Fetal and postnatal hyperthyroidism w as not recognized far the first child who was referred to us at one ye ar of age for craniostenosis. During the two next pregnancies fetal hy perthyroidism was suspected on the basis of fetal tachycardia, growth retardation, fetal goiter and fetal cord blood sampling confirmed high levels of free T3, free T4, suppressed fetal TSH levels, and high lev els of fetal TRAb. The mother received propylthiouracil to control fet al hyperthyroidism. Neither baby was premature and each had a more fav orable outcome than the first. Fetal cord blood sampling proved to be useful during these two pregnancies to ascertain the diagnosis of feta l hyperthyroidism and to monitor the dose of PTU administered to this euthyroid mother.