RELAPSE OF MATERNAL THYROTOXICOSIS PRESENTING AS A 2ND-TRIMESTER FETAL GOITER

A large fetal goiter was detected at 22 weeks of gestation during an a ntenatal ultrasound scan of a woman with a previous history of Graves' disease treated by partial thyroidectomy. This unsuspected finding in itiated maternal investigations and treatment. In untreated cases poor fetal outcome is common and unfortunately fetal thyrotoxicosis/thyroi d enlargement frequently remains unrecognized in the first pregnancy. We report the case and its management and discuss the literature empha sizing the importance of screening for antibodies in the 'at-risk' wom en and the increasing importance of ultrasound in the evaluation and f ollow-up of these patients. Reports of thyrotoxic fetal goiters are ex tremely rare and, to our knowledge, there have been no previous report s of this in the second trimester.