Prenatal Treatment of Fetal Goitrous Hypothyroidism by Intraamniotic Thyroxine

We present the management of a case of fetal goitrous hypothyroidism (FGH) referred to our centre on completion of the 31th week with a view to prenatal treatment. The fetus displayed an anterior neck mass recognizable as thyroid by location and texture. The mother had normal thyroid function tests and no antithyroid antibodies. A cordocentesis was performed to reveal hypothyroid status, also checking the fetal karyotype which was a normal male. Intraamniotic injections of L-thyroxine 500 μg were carried out weekly. After six applications of the dose the pregnancy reached 38+5 weeks when normal delivery ensued, the newborn presenting a euthyroid status. He grew up to a healthy boy, now seven years of age, with completely normal motor and intellectual development. The rationale behind diagnosis, prenatal treatment and appropriateness of such management is discussed in this article.

Prenatal Treatment of Fetal Goitrous Hypothyroidism by Intraamniotic Thyroxine