Gulraze Anjum, Kurdi Wesam, Tulbah Maha, Niaz Faraz Azim
Department of Obstetrics and Gynaecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
J Coll Physicians Surg Pak. 2013 Mar;23(3):216-8.
We describe two cases of fetal goiter in women with no history of thyroid disease. Diagnosis of fetal goiter during antenatal care was made by ultrasound and MRI. Congenital hypothyroidism was confirmed by fetal blood sampling that was treated with weekly intra-amniotic injections of L-thyroxin. One fetus was initially treated with four weekly intra-amniotic injections of 200 μgms of L-thyroxin, later increased to 400 μgms. The other fetus was treated with only three weekly intraamniotic injections of 400 μgms of L-thyroxin. Therapeutic response was monitored by repeated ultrasound and MRI along with fetal blood sampling. At birth, none of the babies had goiter and were put on oral thyroxin. Post-natal studies were suggestive of congenital hypothyroidism due to dyshormogenesis. No abnormality was detected at follow-up. These cases highlight the role of intra-amniotic thyroxine in management of fetal hypothyroidism with goiter.
我们描述了两例无甲状腺疾病病史女性的胎儿甲状腺肿病例。产前检查时通过超声和磁共振成像（MRI）诊断出胎儿甲状腺肿。通过胎儿血样采集确诊先天性甲状腺功能减退症，并通过每周羊膜腔内注射左旋甲状腺素进行治疗。一名胎儿最初每周进行4次羊膜腔内注射200微克左旋甲状腺素，后来增加到400微克。另一名胎儿仅接受了3次每周羊膜腔内注射400微克左旋甲状腺素的治疗。通过重复超声、MRI以及胎儿血样采集监测治疗反应。出生时，所有婴儿均无甲状腺肿，并开始口服甲状腺素。产后研究提示先天性甲状腺功能减退症是由于激素合成障碍所致。随访未发现异常。这些病例突出了羊膜腔内甲状腺素在治疗伴有甲状腺肿的胎儿甲状腺功能减退症中的作用。
