Fetal Pharmacotherapy 4: Fetal Thyroid Disorders

Namouz-Haddad, Shirin; Koren, Gideon

doi:10.1016/s1701-2163(15)30684-8

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…These include the dose and frequency of the LT4 administration (12). Multiple protocols are defined, with different doses of LT4, but the exact pharmacokinetics of amniotic uptake remains unclear (13,14). Current evidence shows the efficacy of ~70% after intra-amniotic therapy (15).…”

Section: Introductionmentioning

confidence: 99%

Conservative in utero treatment of fetal dyshormonogenetic goiter with levothyroxine, a systematic literature review

et al. 2020

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Fetal goitrous hypothyroidism is a rare condition associated with important obstetrical, neonatal complications, and neurodevelopmental impairments. Prenatal treatment remains controversial, and the risk to benefit ratio must be accurately assessed and considered for individualized management. The objective of this review was to evaluate the feasibility, safety, and effectiveness of the conservative in utero treatment of fetal goitrous hypothyroidism. In total, 25 reports that met our inclusion criteria were selected and the management of 38 cases was analyzed. Prenatal diagnosis consisted mainly of ultrasonographic findings. Fetal thyroid status was assessed by cordocentesis. Prenatal treatment varied widely in terms of levothyroxine (LT4) route of administration, dosage, number of injections, and frequency. Although different regimens and routes of administration were proposed, they seem to have similar results regarding fetal goiter reduction and thyroid status at birth. At birth, most babies had hypothyroidism, but the long-term follow-up indicated a normal psycho-neuromotor development. Our data confirm the feasibility of conservative treatment with LT4 for fetal goitrous hypothyroidism. Further studies are needed to determine the optimal management of this disorder.

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Section: Introductionmentioning

confidence: 99%

Conservative in utero treatment of fetal dyshormonogenetic goiter with levothyroxine, a systematic literature review

et al. 2020

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“…6 However because of the unavailability of the parenteral form of the drug, we had to proceed with the maternal oral therapy with T3 which was selected particularly because of its higher potency compared to T4 and rapid transplacental passage. 7 However, we had to be more cautious about the maternal thyrotoxicosis symptoms in this case. Fetal hydrops regressed quickly with the discontinuation of ATD and the initiation of treatment in both.…”

Section: Discussionmentioning

confidence: 92%

Reversal of Propylthiouracil Induced-Fetal Ascites in Monochorionic Twins

Ekmekçi¹,

Esercan²,

Kaplan³

2021

J Clin Obstet Gynecol

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ABS TRACT There are various causes in the etiology of fetal ascites and non-immune hydrops fetalis. Pathogenesis of non-immune hydrops fetalis is incompletely understood. The etiology cannot be determined in yet a large part of cases. Here we reported an isolated fetal ascites case in both fetuses, in a monochorionic pregnancy during maternal propylthiouracil (PTU) use. Fetal goiter was detected in both fetuses and after maternal oral tri-iodothyronine treatment, ascites resolved and babies were delivered at 36 th week of pregnancy. Anti-thyroid drugs (ATDs) should be used carefully during pregnancy. Fetal hypothyroidism may be associated with fetal hyrdrops. Maternal oral tri-iodothyronine administration may treat fetal hypothyroidism.

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“…It is then converted into T 3 . The prenatal therapy schedule is not well standardized . After the injection of l ‐T 4 , the pharmacokinetic profile and the turnover of T 4 in the amniotic fluid have not yet been explored in humans, making it difficult to establish a protocol of care.…”

Section: Discussionmentioning

confidence: 99%

“…The prenatal therapy schedule is not well standardized. 31 After the injection of L-T 4 , the pharmacokinetic profile and the turnover of T 4 in the amniotic fluid have not yet been explored in humans, making it difficult to establish a protocol of care. Consequently, based on different reports, the frequency of injections varies from 1 injection only to 1 per week.…”

Section: Discussionmentioning

confidence: 99%