Fetal goiter conservatively monitored during the prenatal period associated with maternal and neonatal euthyroid status

Neto, José Ferreira Gomes; Júnior, Edward Araujo; Costa, Juliana Nascimento da; Dias, Daniel Aguiar; Aguiar, Lindemberg Barbosa; Carvalho, Francisco Herlânio Costa

doi:10.5468/ogs.2016.59.1.54

Cited by 4 publications

(6 citation statements)

References 11 publications

(17 reference statements)

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“…As a normal thyroid gland’s signal intensity is as low as that of muscle on T2-weighted images, the presence of a signal that is higher than that associated with muscle signifies a hypofunctioning thyroid gland [16]. Table 1 summarizes our review of previous reports that describe MRI findings from fetal goiters between 2000 and 2018 [13,15,[17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]]. Without a maternal thyroid gland abnormality, fetal hypothyroidism is characterized by a fetal thyroid gland that shows a hyperintense signal on T2-weighted images.…”

Section: Diagnosis Of Fetal Goiter and Thyroid Statusmentioning

confidence: 99%

Current knowledge about the in utero and peripartum management of fetal goiter associated with maternal Graves’ disease

Iijima

2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Maternal Graves’ disease is the most common cause of fetal goiter. Fetal goiter can cause complications attributable either to the physical effects of the goiter itself or to thyroid dysfunction, which can be life-threatening and cause neurological impairment. Determining whether a goiter is caused by fetal hyperthyroidism or hypothyroidism is the main clinical problem, and in utero evaluations and management are essential. Ultrasonography combined with color Doppler and magnetic resonance imaging are helpful for the initial diagnosis and monitoring, but these imaging techniques have a limited ability to discriminate between fetal hyperthyroidism and hypothyroidism. To determine the fetal thyroid status, fetal blood sampling using cordocentesis is reliable but hazardous, and the indications must be considered carefully. Amniocentesis is an easier and safer alternative, but the correlations between the amniotic fluid and fetal serum thyroid hormone levels remain unclear. If a fetal goiter is accompanied by hypothyroidism, administering thyroid hormone intra-amniotically may be effective and relatively safe. However, the wide variety of approaches to treatment exemplifies the lack of guidelines, and no systematic studies have been conducted to date. Therefore, intrauterine treatment should be reserved for selected patients at a high risk of complications. Moreover, when intrauterine treatment fails and a fetal goiter can cause airway obstruction, intrapartum management, such as ex utero intrapartum treatment, may be required; however, reports describing the use of this procedure for fetal goiter are limited. This review summarizes the current knowledge about fetal goiter associated with maternal Graves’ disease and evaluates the most significant new findings regarding its in utero and peripartum management.

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Section: Diagnosis Of Fetal Goiter and Thyroid Statusmentioning

confidence: 99%

Current knowledge about the in utero and peripartum management of fetal goiter associated with maternal Graves’ disease

Iijima

2019

European Journal of Obstetrics & Gynecology and Reproductiv

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“…However, first eliminate all differential diagnosis of neck mass [6]. Fetal goiter was defined as a thyroid circumference or diameter > 95 th percentile for gestational age [10][11]. When fetal goiter was found, color flow Doppler examination of the thyroid was performed with the velocity scale adjusted to 13 cm/s.…”

Section: Diagnosismentioning

confidence: 99%

“…The intra-amniotic fetal thyroid hormones level could be an alternative to the FBS [6]. The maternal dosage of the compound W of placental origin could reflect fetal thyroid metabolism and constitute a new option diagnostic [11]. Some authors have used MRI to confirm the diagnosis; however the MRI does not seem at this time make any additional element in the characterization of fetal goiter [11].…”

Section: Diagnosismentioning

confidence: 99%

“…If PTU is maintained, use the lowest possible dosage. The dose should be gradually decreased (so that the maternal fT4 level is at the upper limit of normal) and provide close ultrasound monitoring of the fetal thyroid to detect possible fetal hyperthyroidism transplacental passage of antibody or fetal goiter by transplacental passage of antithyroid [1,3,6,8,11]. If the treatment is continued until the birth, inform the maternity team so that it can adapt the reception of the newborn.…”

Section: Treatmentmentioning

confidence: 99%

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Hyperthyroid Fetal Goiter: A Case Report

Loue¹

2019

JGO

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The persistent presence of maternal thyroid-stimulating hormone receptor antibody in patients with Graves'disease could cause fetal hyperthyroid goiter during pregnancy. The recognition and treatment of hyperthyroid fetal goiter are believed to be very important to optimize growth and intellectual development in affected fetuses. We report here, a case of a hyperthyroid fetal goiter identified by ultrasound exam at 27 weeks 5 days of gestation in a women having Graves' disease and on antithyroid drugs therapy. This observation shows the fetal risk associated with the persistence of anti-TSH receptor antibodies in mothers with Graves' disease and the possibility of fetal approach.

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“…Furthermore, ultrasonography can examine thyroid pressure on other neck organs as well as their displacement 5 . In some cases, thyroid enlargement is detectable in ultrasound examinations during pregnancy 6 . In some centers, after the diagnosis of goiter in the womb, fetal thyroid hormones are examined and the fetus is treated, if necessary 7 .…”

Section: Introductionmentioning

confidence: 99%