Literature DB >> 30705701

Neonatal hypothyroidism despite maternal tri-iodothyronine toxicosis: a management problem?

Vasant V Shenoy1, Janelle Nisbet2, Scott G Petersen3, H David Mcintyre1.   

Abstract

A primigravida was referred with hyperthyroidism in early pregnancy from longstanding Graves' disease treated with propylthiouracil. She had selective elevation of free tri-iodothyronine (fT3) levels, low normal free tetra-iodothyronine (fT4) and suppressed thyroid-stimulating hormone (TSH). Given her symptoms of thyrotoxicosis and elevated TSH receptor antibodies, therapy was tailored towards maintaining clinical and biochemical euthyroidism. However the fetus developed a goitre secondary to hypothyroidism. This case highlights the dilemmas in managing maternal T3 toxicosis while aiming for a high normal fT4 to prevent fetal hypothyroidism including the role of fetal ultrasound monitoring and amniocentesis.

Entities:  

Keywords:  Grave's disease; fetal goitre; fetal hypothyroidism; maternal T3 toxicosis; maternal thyrotoxicosis; pregnancy

Year:  2012        PMID： 30705701      PMCID： PMC6341508          DOI： 10.1258/om.2011.110074

Source DB:  PubMed          Journal:  Obstet Med        ISSN： 1753-495X


  12 in total

Review 1.  The use of antithyroid drugs in pregnancy and lactation.

Authors:  S J Mandel; D S Cooper
Journal:  J Clin Endocrinol Metab       Date:  2001-06       Impact factor: 5.958

2.  Successful in utero treatment of fetal goitrous hypothyroidism: case report and review of the literature.

Authors:  H Hashimoto; K Hashimoto; N Suehara
Journal:  Fetal Diagn Ther       Date:  2006       Impact factor: 2.587

3.  Management of Graves' disease during pregnancy: the key role of fetal thyroid gland monitoring.

Authors:  Dominique Luton; Isabelle Le Gac; Edith Vuillard; Mireille Castanet; Jean Guibourdenche; Michèle Noel; Marie-Elisabeth Toubert; Juliane Léger; Christine Boissinot; Marie-Hélène Schlageter; Catherine Garel; Brigitte Tébeka; Jean-François Oury; Paul Czernichow; Michel Polak
Journal:  J Clin Endocrinol Metab       Date:  2005-08-23       Impact factor: 5.958

Review 4.  Newborn screening for congenital hypothyroidism.

Authors:  Atilla Büyükgebiz
Journal:  J Pediatr Endocrinol Metab       Date:  2006-11       Impact factor: 1.634

5.  Delivery of maternal thyroid hormones to the fetus.

Authors:  Jatin Patel; Kelly Landers; Huika Li; Robin H Mortimer; Kerry Richard
Journal:  Trends Endocrinol Metab       Date:  2011-03-15       Impact factor: 12.015

6.  Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum.

Authors:  Alex Stagnaro-Green; Marcos Abalovich; Erik Alexander; Fereidoun Azizi; Jorge Mestman; Roberto Negro; Angelita Nixon; Elizabeth N Pearce; Offie P Soldin; Scott Sullivan; Wilmar Wiersinga
Journal:  Thyroid       Date:  2011-07-25       Impact factor: 6.568

7.  Establishment of reference intervals for markers of fetal thyroid status in amniotic fluid.

Authors:  Pratima K Singh; Curtis A Parvin; Ann M Gronowski
Journal:  J Clin Endocrinol Metab       Date:  2003-09       Impact factor: 5.958

8.  The relationship between maternal serum thyroid-stimulating immunoglobulin and fetal and neonatal thyrotoxicosis.

Authors:  David Peleg; Sarah Cada; Aviva Peleg; Moshe Ben-Ami
Journal:  Obstet Gynecol       Date:  2002-06       Impact factor: 7.661

9.  Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline.

Authors:  Marcos Abalovich; Nobuyuki Amino; Linda A Barbour; Rhoda H Cobin; Leslie J De Groot; Daniel Glinoer; Susan J Mandel; Alex Stagnaro-Green
Journal:  J Clin Endocrinol Metab       Date:  2007-08       Impact factor: 5.958

10.  Use of ultrasound to distinguish between fetal hyperthyroidism and hypothyroidism on discovery of a goiter.

Authors:  C Huel; J Guibourdenche; E Vuillard; J Ouahba; M Piketty; J F Oury; D Luton
Journal:  Ultrasound Obstet Gynecol       Date:  2009-04       Impact factor: 7.299
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