DIAGNOSIS AND SUCCESSFUL TREATMENT OF FETAL GOITROUS HYPERTHYROIDISM CAUSED BY MATERNAL GRAVES-DISEASE

Background. intrauterine diagnosis and treatment of fetal goitrous hyp erthyroidism due to maternal Graves disease has not been reported. Cas e: A case of fetal goitrous hyperthyroidism caused by maternal Graves disease was diagnosed and treated in the second trimester. High concen trations of both thyroid-stimulatory immunoglobulins (Igs) and thyrotr opin-binding inhibitory Igs were detected in both maternal and fetal u mbilical venous blood. Maternal propylthiouracil (PTU) treatment resul ted in normalization of fetal thyroid function and a decrease in the s ize of the fetal thyroid goiter. Although euthyroid immediately after birth, the infant later became hyperthyroid and required treatment wit h PTU. Conclusion: The relatively high frequency of fetal thyroid diso rders in maternal Graves disease warrants complete maternal and fetal evaluation. Fetal diagnosis and treatment of either hyperthyroidism or hypothyroidism are feasible and necessary to prevent fetal morbidity and mortality.