Cg. Hatjis, DIAGNOSIS AND SUCCESSFUL TREATMENT OF FETAL GOITROUS HYPERTHYROIDISM CAUSED BY MATERNAL GRAVES-DISEASE, Obstetrics and gynecology, 81(5), 1993, pp. 837-839
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.