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碘过量产前补充与胎儿甲状腺肿大:两例应用三维超声及磁共振成像的报告。

Excessive Prenatal Supplementation of Iodine and Fetal Goiter: Report of Two Cases Using Three-dimensional Ultrasound and Magnetic Resonance Imaging.

机构信息

Department of Fetal Medicine, Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ, Brazil.

Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2021 Apr;43(4):317-322. doi: 10.1055/s-0041-1729143. Epub 2021 May 12.

Abstract

Fetal thyroid complications in pregnancy are uncommon, and are commonly related to the passage of substances through the placenta. The excessive iodine intake during the pregnancy is a well-known mechanism of fetal thyroid enlargement or goiter, and invasive procedures have been proposed for the treatment of fetal thyroid pathologies. In the present report, we demonstrate two cases from different centers of prenatal diagnosis of fetal thyroid enlargement and/or goiter in three fetuses (one pair of twins, wherein both fetuses were affected, and one singleton pregnancy). The anamnesis revealed the ingestion of iodine by the patients, prescribed from inadequate vitamin supplementation. In both cases, the cessation of iodine supplement intake resulted in a marked reduction of the volume of the fetal thyroid glands, demonstrating that conservative treatment may be an option in those cases. Also, clinicians must be aware that patients may be exposed to harmful dosages or substances during pregnancy.

摘要

妊娠期间胎儿甲状腺并发症并不常见,通常与物质通过胎盘有关。妊娠期间碘摄入过多是胎儿甲状腺肿大或甲状腺肿的已知机制,已经提出了侵入性程序来治疗胎儿甲状腺病变。在本报告中,我们展示了来自不同中心的两例产前诊断,涉及 3 例胎儿(一对双胞胎,其中两个胎儿均受影响,以及一例单胎妊娠)的胎儿甲状腺肿大和/或甲状腺肿。病史显示患者摄入了碘,这是由不适当的维生素补充剂引起的。在这两种情况下,停止碘补充摄入后,胎儿甲状腺的体积明显减少,这表明在这些情况下保守治疗可能是一种选择。此外,临床医生必须意识到,孕妇在怀孕期间可能会接触到有害剂量或物质。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f70a/10183920/d9310199f090/10-1055-s-0041-1729143-i200047-1.jpg

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