Abuhamad A Z, Fisher D A, Warsof S L, Slotnick R N, Pyle P G, Wu S Y, Evans A T
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, USA.
Ultrasound Obstet Gynecol. 1995 Nov;6(5):368-71. doi: 10.1046/j.1469-0705.1995.06050368.x.
The recognition and treatment of fetal hypothyroidism are believed to be important to optimize growth and intellectual development in affected fetuses. We present a case of fetal goiter diagnosed by ultrasonography in the second trimester of pregnancy. Cordocentesis performed at 28 weeks confirmed the presence of fetal hypothyroidism. Fetal therapy was performed with weekly intra-amniotic injections of thyroxine from 29 to 36 weeks. A repeat cordocentesis at 35 weeks showed normalization of fetal thyroid function. The fetal goiter decreased rapidly in size following fetal treatment. Amniotic fluid levels of thyroid stimulating hormone (TSH) and free thyroxine were obtained with each amniocentesis. Sulfated iodothyronine concentrations in maternal blood were obtained before and after fetal thyroxine treatment. This report discusses the role of amniotic fluid levels of TSH and free thyroxine and maternal levels of sulfated iodothyronine in the diagnosis and management of fetal hypothyroidism. A review of the English literature is presented.
胎儿甲状腺功能减退的识别与治疗对于优化受影响胎儿的生长及智力发育至关重要。我们报告一例在妊娠中期通过超声诊断出的胎儿甲状腺肿病例。孕28周时进行的脐血穿刺术证实存在胎儿甲状腺功能减退。从孕29周直至36周，每周进行羊膜腔内甲状腺素注射以进行胎儿治疗。孕35周时再次进行脐血穿刺术显示胎儿甲状腺功能恢复正常。胎儿接受治疗后，胎儿甲状腺肿的大小迅速减小。每次羊膜腔穿刺术均获取羊水促甲状腺激素（TSH）和游离甲状腺素水平。在胎儿甲状腺素治疗前后获取母体血液中的硫酸化碘甲腺原氨酸浓度。本报告讨论了羊水TSH和游离甲状腺素水平以及母体硫酸化碘甲腺原氨酸水平在胎儿甲状腺功能减退诊断和管理中的作用。并对英文文献进行了综述。
