Bruner J P, Dellinger E H
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tenn. 37232-2519, USA.
Fetal Diagn Ther. 1997 Jul-Aug;12(4):200-4. doi: 10.1159/000264468.
Fetal goiter in the presence of maternal Graves' disease can signify either hyperthyroidism or hypothyroidism in the fetus. Two patients with Graves' disease taking propylthiouracil were found to have a fetal goiter on a prenatal sonogram. Fetal blood sampling identified hypothyroidism in both instances. Administration of intraamniotic thyroxine resulted in rapid resolution of the goiter, normalization of subsequent fetal thyroid studies, and delivery of a euthyroid fetus. Cordocentesis allows accurate diagnosis and follow-up of fetal thyroid dysfunction and prompt initiation of appropriate therapy.
孕妇患格雷夫斯病时胎儿出现甲状腺肿可能意味着胎儿甲状腺功能亢进或减退。两名患格雷夫斯病且正在服用丙硫氧嘧啶的孕妇在产前超声检查中发现胎儿有甲状腺肿。两次胎儿血样采集均确诊为甲状腺功能减退。羊膜腔内注射甲状腺素后甲状腺肿迅速消退，随后胎儿甲状腺检查恢复正常，分娩出甲状腺功能正常的胎儿。脐静脉穿刺术可准确诊断和随访胎儿甲状腺功能障碍，并能迅速启动适当治疗。
