碘诱导的胎儿甲状腺功能减退症：羊膜内左甲状腺素治疗和诊断。
Iodine-Induced Fetal Hypothyroidism: Diagnosis and Treatment with Intra-Amniotic Levothyroxine.
机构信息
Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
出版信息
Horm Res Paediatr. 2018;90(6):419-423. doi: 10.1159/000488776. Epub 2018 May 23.
BACKGROUND
Iodine is necessary for fetal thyroid development. Excess maternal intake of iodine can cause fetal hypothyroidism due to the inability to escape from the Wolff-Chaikoff effect in utero.
CASE REPORT
We report a case of fetal hypothyroid goiter secondary to inadvertent excess maternal iodine ingestion from infertility supplements. The fetus was successfully treated with intra-amniotic levothyroxine injections. Serial fetal blood sampling confirmed fetal escape from the Wolff-Chaikoff effect in the mid third trimester. Early hearing test and neurodevelopmental milestones were normal.
CONCLUSION
Intra-amniotic treatment of fetal hypothyroidism may decrease the rate of impaired neurodevelopment and sensorineural hearing loss.
背景
碘是胎儿甲状腺发育所必需的。母体摄入过多的碘会导致胎儿甲状腺功能减退，这是因为胎儿在子宫内无法逃脱 Wolff-Chaikoff 效应。
病例报告
我们报告了一例因不孕补充剂意外摄入过多母体碘而导致胎儿甲状腺肿性甲状腺功能减退症的病例。胎儿成功接受了羊膜内左甲状腺素注射治疗。连续的胎儿血液取样证实胎儿在妊娠中期成功逃脱了 Wolff-Chaikoff 效应。早期听力测试和神经发育里程碑均正常。
结论
羊膜内治疗胎儿甲状腺功能减退症可能会降低神经发育受损和感觉神经性听力损失的发生率。
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