Antenatal treatment of fetal goiter: a therapeutic challenge

Hanono, Anat; Shah, Bina; David, Raphael; Buterman, Irving; Roshan, Daniel; Shah, Shetal; Lam, Leslie; Timor‐Tritsch, I. E.

doi:10.1080/14767050802448299

Cited by 28 publications

(21 citation statements)

References 24 publications

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“…16 Studies suggest that serial ultrasonographic monitoring of fetal goiter size is helpful. 10 Studies on the thyroid vascular pattern using color Doppler are under investigation.…”

mentioning

confidence: 99%

Prenatal Diagnosis of Fetal Goiter in a Euthyroid Mother

et al. 2015

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Congenital fetal goiter is a very rare pathology, is sometimes difficult to diagnose when there is no maternal history or the goiter size is moderate. We report a case of prenatally diagnosed fetal goiter in a euthyroid mother. A 28-year-old woman was referred to our clinic at 38 +2 weeks of gestation. Ultrasonographic examination revealed a fetal goiter. The maternal history and thyroid function tests, including antithyroid autoantibody tests, were unremarkable. Cesarean section was performed, and the thyroid profile of the neonate was consistent with congenital hypothyroidism. Thyroxine therapy was immediately started. Fetal thyroid function must be determined when a goiter is detected. Cordocentesis is a more reliable but riskier diagnostic tool than amniocentesis. Intra-amniotic injection of thyroxine is relatively safe and an easier management option for fetal hypothyroidism. To develop more noninvasive and safe methods for therapeutic efficacy monitoring, a large-scale study is necessary.

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“…16 Studies suggest that serial ultrasonographic monitoring of fetal goiter size is helpful. 10 Studies on the thyroid vascular pattern using color Doppler are under investigation.…”

mentioning

confidence: 99%

Prenatal Diagnosis of Fetal Goiter in a Euthyroid Mother

et al. 2015

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“…Prior reports have advocated for cordocentesis and intra-amniotic thyroid hormone therapy in order to confirm the diagnosis of fetal thyroid dysfunction, reduce the size of the fetal goiter, reduce polyhydramnios, aid with the assistance of maternal thyroid hormone therapy and reduce fetal malpresentation [9,10,11,12,13]. Such reports of in utero therapy often describe serial (sometimes weekly) amniocentesis procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Such reports of in utero therapy often describe serial (sometimes weekly) amniocentesis procedures. It is important to remember that invasive procedures harbor a small but not insignificant risk of PPROM (preterm premature rupture of membranes) and chorioamnionitis, both of which have previously been reported in the setting of fetal goiter treatment [10]. Moreover, in a recent series of 12 cases treated with in utero therapy following invasive assessments of fetal thyroid status, all cases were associated with newborn hypothyroidism at birth [13].…”

Section: Discussionmentioning

confidence: 99%

Conservatively Managed Fetal Goiter: An Alternative to in utero Therapy

Blumenfeld

Davis²,

Milan

et al. 2013

Fetal Diagn Ther

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Fetal goiter may arise from a variety of etiologies including iodine deficiency, overtreatment of maternal Graves' disease, inappropriate maternal thyroid replacement and, rarely, congenital hypothyroidism. Fetal goiter is often associated with a retroflexed neck and polyhydramnios, raising concerns regarding airway obstruction in such cases. Prior reports have advocated for cordocentesis and intra-amniotic thyroid hormone therapy in order to confirm the diagnosis of fetal thyroid dysfunction, reduce the size of the fetal goiter, reduce polyhydramnios, aid with the assistance of maternal thyroid hormone therapy and reduce fetal malpresentation. We report two cases of conservatively managed fetal goiter, one resulting in a vaginal delivery, and no evidence of postnatal respiratory distress despite the presence of polyhydramnios and a retroflexed neck on prenatal ultrasound.

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“…Mainly, this is possible for diagnosis of fetal goitrous hypothyroidism. There are several reports on the successful intrauterine treatment of goitrous hypothyroidism with repeated intraamniotic injection of L-thyroxine [3][4][5][6][7][8][9][10]. Such a treatment must follow the precise ultrasound assessment of the mass and, importantly, an amniocentesis to obtain the results of TSH, fT3 and fT4 concentrations in the amniotic fluid.…”

Section: Intrauterine Therapymentioning

confidence: 99%

Fetal neck tumors – antenatal and intrapartum management

Kornacki

Skrzypczak

2017

Ginekol Pol

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In this review article we describe the ante-and perinatal management of fetal neck tumors. Although there are rare congenital anomalies, the clinical consequences for the fetus may be fatal and include airways obstruction, heart insufficiency, pulmonary hypoplasia and cosmetic effect. The right management allows to decrease the fetal and neonatal mortality and morbidity associated with the disease. It includes intrauterine therapy in some cases, mostly in a goitrus hypothyroidism of the fetus, but firstly, an assessment of the fetal airways patency with a subsequent, eventual Ex-Utero Intrapartum Treatment (EXIT).

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Antenatal treatment of fetal goiter: a therapeutic challenge

Cited by 28 publications

References 24 publications

Prenatal Diagnosis of Fetal Goiter in a Euthyroid Mother

Prenatal Diagnosis of Fetal Goiter in a Euthyroid Mother

Conservatively Managed Fetal Goiter: An Alternative to in utero Therapy

Fetal neck tumors – antenatal and intrapartum management

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