Prenatal Diagnosis and Management of Fetal Goiter Treated Successfully with Intra-Amniotic Levothyroxine

Valentina Corda,Cristina Peddes,Ambra Iuculano,Giovanni Monni

doi:10.4236/ojog.2021.111006

Abstract

Goiter is an enlargement of the thyroid gland which can be associated with a number of complications both for the mother and the fetus. A 34-year-old pregnant woman with normal thyroid function was referred to our Department of Obstetrics and Gynecology at Microcitemico Pediatric Hospital, Cagliari, for suspected fetal goiter at 32 gestational weeks. The case was monitored regularly by ultrasound and treated successfully with intra-amniotic levothyroxine (L-T4) administration. Fetal goiter was observed to decrease after this treatment and the thyroid ultrasound findings were also normal both at birth and in subsequent follow-ups. Our case report confirms the feasibility of conservative treatment with L-T4, which can effectively prevent complications related to fetal goiter.

Highlights

A 34-year-old pregnant woman with normal thyroid function was referred to our Department of Obstetrics and Gynecology at Microcitemico Pediatric Hospital, Cagliari, for suspected fetal goiter at 32 gestational weeks
Our case report confirms the feasibility of conservative treatment with L-T4, which can effectively prevent complications related to fetal goiter
Incidence of fetal goiter is 1 in 40,000 deliveries [3] and it can be associated with hyperthyroidism, hypothyroidism or an euthyroid state

Summary

Introduction

Incidence of fetal goiter is 1 in 40,000 deliveries [3] and it can be associated with hyperthyroidism, hypothyroidism or an euthyroid state. Fetal goiter is responsible for about 10% - 15% of fetuses with congenital hypothyroidism [4]. Other conditions associated with fetal goiter are: dysgenesis, dyshormonogenesis, transplacental passage of maternal antibodies, thyroid stimulating hormone receptor mutations, and tumors [5]. Most cases of fetal goiter are associated with maternal thyroid dysfunction, some cases of euthyroid pregnant women are reported too [6]. Previous reports on fetal goiter hypothyroidism treated with intra-amniotic levothyroxine (L-T4) showed that patients who had intra-amniotic L-T4 administration were likely to have a favourable outcome compared with patients who did not [7]

Case Presentation

Corda et al DOI

Discussion

Conclusions