成功治疗胎儿甲状腺功能亢进继发的复发性非免疫性水肿。

Successful treatment of recurrent non-immune hydrops secondary to fetal hyperthyroidism.

作者信息

Treadwell M C, Sherer D M, Sacks A J, Ghezzi F, Romero R

机构信息

Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, Michigan, USA.

出版信息

Obstet Gynecol. 1996 May;87(5 Pt 2):838-40.

PMID:8677108

Abstract

BACKGROUND

Non-immune fetal hydrops is a heterogeneous disorder with a mortality rate of 50-98%. Resolution of non-immune fetal hydrops is rare but has been reported to occur spontaneously or after targeted therapeutic measures.

CASE

A euthyroid gravida with Graves disease presented with a history of three prior perinatal deaths between 26 and 28 weeks' gestation, all associated with fetal hydrops. In the current pregnancy, the fetus developed hydrops at 24 weeks' gestation. Fetal hyperthyroidism, with high-output cardiac failure, was diagnosed with fetal blood sampling. After maternal therapy with propylthiouracil, resolution of the non-immune hydrops were documented and a healthy neonate subsequently delivered to term. The neonate developed transient hyperthyroidism after delivery, which required treatment for 10 weeks.

CONCLUSION

Non-immune hydrops occurring as a result of fetal hyperthyroidism with high output cardiac failure is treatable with propylthiouracil.

摘要

背景

非免疫性胎儿水肿是一种异质性疾病，死亡率为50%至98%。非免疫性胎儿水肿很少消退，但有报道称可自发消退或在采取针对性治疗措施后消退。

病例

一名患有格雷夫斯病的甲状腺功能正常孕妇，有三次妊娠晚期（妊娠26至28周）围产期死亡史，均与胎儿水肿有关。在本次妊娠中，胎儿在妊娠24周时出现水肿。通过胎儿血样采集诊断为胎儿甲状腺功能亢进伴高输出量心力衰竭。在孕妇接受丙硫氧嘧啶治疗后，记录到非免疫性水肿消退，随后足月分娩出一名健康新生儿。新生儿出生后出现短暂性甲状腺功能亢进，需要治疗10周。