Léger J, Le Guern H, Plouhinec C, Brauner R, Czernichow P
Unité d'Endocrinologie pédiatrique, Hôpital des Enfants malades, Paris.
Presse Med. 1987 Sep 26;16(31):1521-6.
A case of foetal goiter diagnosed by ultrasonography is reported. A first child had been under treatment since the age of 4 months for goitrous hypothyroidism. A second pregnancy developed normally. However, at 27 weeks a first ultrasonography showed hypertrophy of the foetus' thyroid gland, and this was confirmed by a second ultrasonic examination performed at 34 weeks. The femoral ossification centre, which usually appears between 31 and 33 weeks of amenorrhoea, was absent. The child was born at 41 weeks. Additional examinations confirmed the presence of hypothyroidism with goiter and disorders of organification. This is the third case of foetal goiter discovered in utero by ultrasonography. The important therapeutic implications of such a diagnosis (appropriate neonatal intensive care in case of compressive goiter, very early treatment of hypothyroidism) open new possibilities of monitoring in pregnant women whose history suggests a risk of foetal goiter.
本文报道了一例通过超声诊断的胎儿甲状腺肿病例。第一个孩子自4个月大起就因甲状腺肿性甲状腺功能减退接受治疗。第二次怀孕过程正常。然而,在孕27周时,首次超声检查显示胎儿甲状腺肿大,34周时进行的第二次超声检查证实了这一情况。通常在闭经31至33周之间出现的股骨骨化中心未出现。该婴儿在41周时出生。进一步检查证实存在甲状腺肿伴甲状腺功能减退及有机化障碍。这是第三例通过超声在子宫内发现的胎儿甲状腺肿病例。这种诊断具有重要的治疗意义(对于压迫性甲状腺肿需进行适当的新生儿重症监护,对甲状腺功能减退进行极早期治疗),为有胎儿甲状腺肿风险病史的孕妇的监测开辟了新的可能性。