Successful outcome of pregnancy in a thyroidectomized-parathyroidectomizedyoung woman affected by severe hypothyroidism

Severe hypothyroidism was discovered in a young woman in her 29th week of p regnancy. Previously, at the age of 12 years, she had undergone thyroid sur gery for Graves' disease that resulted in persistent hypothyroidism and hyp oparathyroidism. After surgical excision, the patient started levothyroxine replacement therapy and had regular control of thyroid function with norma l findings throughout the years. The dose of levothyroxine had not been adj usted when the pregnancy started, and at the 29th week of gestation the pat ient had a thyrotropin (TSH) of 72.4 mu U/mL. Ultrasound studies were perfo rmed in order to monitor fetal development. The fetal parameters analyzed b efore the adjustment of levothyroxine therapy showed growth retardation of various degrees. All analyzed fetal parameters (biparietal diameter, crania l and abdominal circumference, humerus and femur length) improved during th e last 6 weeks of gestation, showing a good correlation with the newly achi eved euthyroid state of the mother. The infant was clinically euthyroid at birth and was found normal at all evaluations of the neonatal hypothyroidis m screening program (1, 5, 30 days).