Ultrasonography of the fetal thyroid: nomograms based on biparietal diameter and gestational age.

Ranzini, Angela C.; Ananth, Cande V.; Smulian, John C.; Kung, Michelle; Limbachia, Anita; Vintzileos, Anthony M.

doi:10.7863/jum.2001.20.6.613

Cited by 99 publications

(73 citation statements)

References 15 publications

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“…Goiter was defined as a thyroid gland volume equal to or greater than the meanC2 S.D. or as a thyroid gland diameter equal to or greater than the 95th percentile (28). Echocardiography was done in 60 of the 68 patients.…”

Section: Methodsmentioning

confidence: 99%

Management of neonates born to women with Graves' disease: a cohort study

Besançon

Beltrand

Gac

et al. 2014

European Journal of Endocrinology

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Objective: Hyperthyroidism in neonates born to mothers with Graves' disease (GD) can be associated with significant morbidity and mortality, but is still overlooked by clinicians. Management of neonatal hyperthyroidism would be improved by a better understanding of the predictive factors involved. The aim of this study was to evaluate the course of thyroid function and clinical outcomes during the first postnatal month in babies born to mothers with GD. Design: Prospective observational study. Methods: Sixty-eight neonates born to mothers with GD were managed from birth and divided into three groups based on thyrotropin receptor antibody (TRAb) and anti-thyroid drug (ATD) status in the mother: TRAb /ATDCve neonates, 24 (72.7%) had positive TRAb on cord blood assays, and seven of these developed neonatal hyperthyroidism. FT 4 elevation between days 3 and 7 but not at birth was predictive of the development of hyperthyroidism. Conclusions: TRAb status should be checked in the third trimester in mothers with GD and on cord blood in their neonates; if positive, it indicates a high risk of neonatal hyperthyroidism. FT 4 measurement at birth should be repeated between days 3 and 5 (and by day 7 at the latest); rapid FT 4 elevation during the first postnatal week is predictive of hyperthyroidism and warrants ATD therapy.

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Section: Methodsmentioning

confidence: 99%

Management of neonates born to women with Graves' disease: a cohort study

Besançon

Beltrand

Gac

et al. 2014

European Journal of Endocrinology

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“…Nevertheless, Cohen et al 8 published a reference on fetal gland measurements to be used as a tool in following fetuses of hyperthyroidism-affected pregnant women. Perhaps the most complete set of reference ranks for a normal fetal thyroid circumference, however, are those published by Ranzini et al 9 and Ho and Metreweli. 10 Both groups published nomograms on fetal thyroid volume, describing reliable normal ranks that are remarkably similar to those described in this report.…”

Section: Discussionmentioning

confidence: 99%

“…5 Current research in this field is focused on biochemical determinations rather than imaging techniques. 6 Few published reports mention the use of sonography and color Doppler imaging [7][8][9] and also show that volumetric calculations based on 2-dimensional (2D) images have been evaluated [10][11][12][13] as potentially useful tools. Our aim was to try a new approach, using the 3-dimensional power Doppler (3DPD) signal for quantifying vascularization inside the mass, and to use it as a potential indicator of diminishing perfusion and regression of the goiter.…”

mentioning

confidence: 99%

Use of 3-Dimensional Sonography for Prenatal Evaluation and Follow-up of Fetal Goitrous Hypothyroidism

Marín

Bello-Muñoz²,

Martínez³

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Fetal goitrous hypothyroidism is a rare and potentially lethal condition. Consequently, its early diagnosis and treatment improve prognosis. Thyroid hormone measurement in either fetal serum or amniotic fluid implies important risks. Here we present a fetal goiter and the follow-up procedure, both done by the traditional method and by using 3-dimensional power Doppler (3DPD) imaging and virtual organ computer-aided analysis (VOCAL). Methods. A single well-documented case of fetal goiter was followed weekly from 22 weeks until delivery. Amniocentesis for thyrotropin (TSH) and free thyroxine (T 4 ) measurement as well as levothyroxine injections were performed at every control. In addition to amniocentesis, every control involved a sonographic evaluation, which included standard measurements of the gland and the capture of volume image sets in gray scale and 3DPD. Volume calculation of the gland was done using VOCAL software. Vascularization of the gland was evaluated by the vascularization index (VI) included in the software. Results. With treatment, TSH levels decreased progressively until normalization. Free T 4 levels increased toward the end of gestation. Sonographic measurements of the gland volume to estimated fetal weight ratio decreased across treatment as levels of TSH did. The VI clearly depicted the vascular regression of the goiter, decreasing throughout treatment in a consistent way until 24 hours before delivery. Conclusions. Gray scale and 3DPD evaluations of the thyroid gland have been validated under similar circumstances and might be reliable complements to the invasive methods used in the management of this fetal condition.

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“…Fetal thyroid size was assessed by ultrasonograms obtained during pregnancy and compared with the normative data reported by Ho & Metreweli (19) for volume and Ranzini et al (20) for diameter. Goiter was defined as a thyroid gland volume equal to or greater than the mean C2 S.D.…”

Section: Fetal and Neonatal Evaluationsmentioning

confidence: 99%

“…Goiter was defined as a thyroid gland volume equal to or greater than the mean C2 S.D. (19) or as a thyroid gland diameter equal to or greater than the 95th percentile (20).…”

Section: Fetal and Neonatal Evaluationsmentioning

confidence: 99%

Pregnancy in women heterozygous for MCT8 mutations: risk of maternal hypothyroxinemia and fetal care

Ramos

Morandini

Carré

et al. 2011

European Journal of Endocrinology

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Context: Monocarboxylate transporter 8 (MCT8 or SLC16A2) mutations cause X-linked AllanHerndon-Dudley syndrome. Heterozygous females are usually asymptomatic, but pregnancy may modify thyroid function and MCT8 is expressed in the placenta, suggesting that maternal and fetal abnormalities might develop even in the absence of MCT8 fetal mutation. Genetic counseling is so far based on X-linked transmission, and prenatal diagnosis is rarely performed. Objective: To describe thyroid function and the prenatal diagnosis in pregnant mothers harboring heterozygous MCT8 mutations and management of the persistent maternal hypothyroxinemia. Patients: Two women heterozygous for MCT8 mutations (c.1690GOA and c.1393-1GOC) were monitored throughout pregnancy. Methods: Prenatal diagnosis included sex determination, direct MCT8 sequencing, and familial linkage analysis. Ultrasonography and hormonal assays for maternal thyroid function evaluation were performed serially during pregnancy. Neonatal thyroid hormonal status was assessed. Results: None of the three fetuses (two males and one female) carried MCT8 mutations. One of the two heterozygous mothers revealed gestational hypothyroxinemia, prompting early levothyroxine (L-T 4 ) therapy until delivery. The second heterozygous mother showed normal thyroid function but was preventively traited by L-T 4 and all of the three neonates had normal thyroid hormone levels and thyroid gland at birth, suggesting advantages of prenatal care and/or compensatory mechanisms. Conclusion: Heterozygous MCT8 women should be monitored for requirement of L-T 4 therapy to prevent fetal and neonatal hypothyroidism and to avoid risk of potential cognitive delay due to gestational hypothyroxinemia. Moreover, when the disease-causing mutation is known and/or the first child is affected, prenatal diagnosis for male fetuses should be assessed early for MCT8 mutations by direct sequencing.

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Ultrasonography of the fetal thyroid: nomograms based on biparietal diameter and gestational age.

Cited by 99 publications

References 15 publications

Management of neonates born to women with Graves' disease: a cohort study

Management of neonates born to women with Graves' disease: a cohort study

Use of 3-Dimensional Sonography for Prenatal Evaluation and Follow-up of Fetal Goitrous Hypothyroidism

Pregnancy in women heterozygous for MCT8 mutations: risk of maternal hypothyroxinemia and fetal care

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