ANTENATAL DIAGNOSIS AND TREATMENT OF FETAL GOITROUS HYPOTHYROIDISM - CASE-REPORT AND REVIEW OF THE LITERATURE

The recognition and treatment of fetal hypothyroidism are believed to be important to optimize growth and intellectual development in affect ed fetuses, We present a case of fetal goiter diagnosed by ultrasonogr aphy in the second trimester of pregnancy. Cordocentesis performed at 28 weeks confirmed the presence of fetal hypothyroidism. Fetal therapy was performed with weekly intra-amniotic injections of thyroxine from 29 to 36 weeks. A repeat cordocentesis at 35 weeks showed normalizati on of fetal thyroid function. The fetal goiter decreased rapidly in si ze following fetal treatment. Amniotic fluid levels of thyroid stimula ting hormone (TSH) and free thyroxine,cere obtained with each amniocen tesis. Sulfated iodothyronine concentrations in maternal blood were ob tained before and after fetal thyroxine treatment. This report discuss es the role of amniotic fluid levels of TSH and free thyroxine and mat ernal levels of sulfated iodothyronine in the diagnosis and management of fetal hypothyroidism. A review of the English literature is presen ted.