Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, Calif., USA.
Fetal Diagn Ther. 2013;34(3):184-7. doi: 10.1159/000353387. Epub 2013 Jul 31.
Fetal goiter may arise from a variety of etiologies including iodine deficiency, overtreatment of maternal Graves' disease, inappropriate maternal thyroid replacement and, rarely, congenital hypothyroidism. Fetal goiter is often associated with a retroflexed neck and polyhydramnios, raising concerns regarding airway obstruction in such cases. Prior reports have advocated for cordocentesis and intra-amniotic thyroid hormone therapy in order to confirm the diagnosis of fetal thyroid dysfunction, reduce the size of the fetal goiter, reduce polyhydramnios, aid with the assistance of maternal thyroid hormone therapy and reduce fetal malpresentation. We report two cases of conservatively managed fetal goiter, one resulting in a vaginal delivery, and no evidence of postnatal respiratory distress despite the presence of polyhydramnios and a retroflexed neck on prenatal ultrasound.
胎儿甲状腺肿可由多种病因引起，包括碘缺乏、母体格雷夫斯病的过度治疗、不适当的母体甲状腺素替代治疗，以及罕见的先天性甲状腺功能减退症。胎儿甲状腺肿常伴有颈部后倾和羊水过多，这使得人们对这些病例中的气道阻塞产生担忧。先前的报告主张行脐带穿刺和羊膜内甲状腺激素治疗，以确认胎儿甲状腺功能障碍的诊断，减小胎儿甲状腺肿的大小，减少羊水过多，辅助母亲甲状腺激素治疗，并减少胎儿胎位不正。我们报告了两例保守治疗的胎儿甲状腺肿病例，其中一例经阴道分娩，尽管产前超声显示羊水过多和颈部后倾，但无产后呼吸窘迫的证据。
