Luton D, Fried D, Sibony O, Vuillard E, Tebeka B, Boissinot C, Léger J, Polak M, Oury J F, Blot P
Département de Périnatalogie, Hôpital Robert-Debré, Paris, France.
Fetal Diagn Ther. 1997 Jan-Feb;12(1):24-7. doi: 10.1159/000264419.
The association of hyperthyroidism and pregnancy is a rare but serious condition which can jeopardize fetal outcome. Classical follow-up relies on: serial clinical and echographic assessment; serial funipuncture to determine fetal thyroid status, and maternal propylthiouracil (PTU) treatment to treat fetal and/or maternal hyperthyroidism.
We report the case of a euthyroid patient with Graves' disease who had already been delivered of two hyperthyroid fetuses; the present pregnancy revealed a hyperthyroid fetus diagnosed by funipuncture. Echography showed a fetal goiter at 28 weeks of gestation (WG) with important signal on colored Doppler echography. We observed an extinction of this signal as maternal PTU treatment was intensified. The patient was delivered of a mildly hyperthyroid newborn at 37 WG. Both newborn and patient are doing well.
Fetal thyroid assessment by colored Doppler echography could help in the management of fetal thyroid dysfunction.
甲状腺功能亢进与妊娠相关是一种罕见但严重的情况，可能危及胎儿结局。传统的随访依赖于：系列临床和超声评估；系列脐血穿刺以确定胎儿甲状腺状态，以及母体丙硫氧嘧啶（PTU）治疗以治疗胎儿和/或母体甲状腺功能亢进。
我们报告一例患有格雷夫斯病的甲状腺功能正常患者，她已分娩出两个甲状腺功能亢进的胎儿；此次妊娠经脐血穿刺诊断出一个甲状腺功能亢进的胎儿。超声检查显示妊娠28周（WG）时胎儿有甲状腺肿，彩色多普勒超声检查有明显信号。随着母体PTU治疗的加强，我们观察到该信号消失。患者在妊娠37周时分娩出一名轻度甲状腺功能亢进的新生儿。新生儿和患者情况均良好。
彩色多普勒超声评估胎儿甲状腺有助于处理胎儿甲状腺功能障碍。
