Ultrasound in diagnosis of fetal goitrous hypothyroidism (literature review and case report)
Abstract
Case of fetal goiter is presented. At 39 week of gestation because of the labor beginning the patient underwent caesarean section. Diagnosis was established after birth. Ultrasound signs of fetal goiter at 32 weeks 5 days of gestation are described. A solid mass was identified in the anterior aspect of neck. The mass was located symmetrically in relation to the median line. Head hyperextension due to the large size of the mass and polyhydramnios associated with the esophagus compression were also marked. Brief literature review is presented. In the world practice, for prenatal thyroid function assessment cordocentesis for fetal serum sampling with determination of thyroid hormones is recommended. For fetal therapy of hypothyroidism intra-amniotic injections of thyroxine is used. As a result of treatment fetal thyroid function normalizes, fetal thyroid size decreases, fetal head flexion improves, which contributes to the ability to natural childbirth. In our case, fetus treatment was not spending due to the lack of a clear understanding about the nature of identified mass.
About the Authors
N. V. Mashinets
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
V. N. Demidov
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
A. V. Bolmasova
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
E. A. Filippova
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
M. A. Melikyan
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
References
1. Алтухова В.И., Бархина Т.Г., Кузнецова Л.В., Лещенко И.Е. Эндокринная система // Внутриутробное развитие человека / Под ред. А.П. Милованова, С.В. Савельева. М.: МДВ, 2006. С. 203-253.
2. Huel C., Guibourdenche J., Vuillard E., Ouahba J., Piety M., Oury J.F., Luton D. Use of ultrasound to distinguish between fetal hyperthyroidism and hypothyroidism on discovery of a goiter // Ultrasound Obstet. Gynecol. 2009. V. 33. No. 4. P. 412-420.
3. Fisher D.A., Klein A.H. Thyroid development and disorders of thyroid function in the newborn // N. Engl. J. Med. 1981. V. 304. No. 12. P. 702-712.
4. Weiner S., Scharf J.I., Bolognese R.J., Librizzi R.J. Antenatal diagnosis and treatment of a fetal goiter // J. Reprod. Med. 1980. V. 24. No. 1. P. 39-42.
5. Morine M., Takeda T., Minekawa R., Sugiyama T., Wasada K., Mizutani T., Suehara N. Antenatal diagnosis and treatment of a case of fetal goitrous hypothyroidism associated with high-output cardiac failure // Ultrasound Obstet. Gynecol. 2002. V. 19. No. 5. P. 506-509.
6. Abuhamad A.Z., Fisher D.A., Warsof S.L., Slotnick R.N., Pyle P.G., Wu S.Y., Evans A.T. Antenatal diagnosis and treatment of fetal goitrous hypothyroidism: case report and review of the literature // Ultrasound Obstet. Gynecol. 1995. V. 6. No. 5. P. 368-371.
7. Agrawal P., Ogilvy-Stuart A., Lees C. Intrauterine diagnosis and management of congenital goitrous hypothyroidism // Ultrasound Obstet. Gynecol. 2002. V. 19. No. 5. P. 501-505.
8. Nath C.A., Oyelese Y., Yeo L., Chavez M., Kontopoulos E.V., Giannini G., Smulian J.C., Vintzileos A.M. Three-dimensional sonography in the evaluation and management of fetal goiter // Ultrasound Obstet. Gynecol. 2005. V. 25. No. 3. P. 312-314.
9. Бондаренко Н.Н., Андреева Е.Ю. Случай пренатальной диагностики врожденного зоба в 24-25 нед беременности // Пренатальная диагностика. 2013. Т. 12. № 2. С. 147-150.
10. Goldberg Y., Zalmon-Koren I., Keidar R., Auslender R. Antenatal diagnosis and treatment of fetal goiter with a single intraamniotic injection of L-thyroxin - case report // Ultrasound Obstet. Gynecol. 2009. V. 34. Suppl. 1. P. 177-284.
11. Look J., Kim M., Lee M., Park S., Cho D. A case of intraamniotic thyroxine treatment in fetal goiter // Ultrasound Obstet. Gynecol. 2011. V. 38. Suppl. 1. P. 168-281.
12. Stewart C.J., Constantatos S., Muller L.M. Antenatal treatment of fetal goitrous hypothyroidism // Ultrasound Obstet. Gynecol. 2010. V. 36.Suppl. 1. P. 168-305.
13. Okumura M., Maganha C.A., Bunduki V., Ruano R., Medeiros-Neto G., Zugaib M. Prenatal diagnosis and management of fetal goiter associated with maternal Graves’ disease // Ultrasound Obstet. Gynecol. 2004. V. 24. No. 3. P. 354.
14. Sagot P., David A., Yvinec M., Posset P., Papon V., Mouzard A., Boog G. Intrauterine treatment of thyroid goiters // Fetal Diagn. Ther. 1991. V. 6. No. 1-2. P. 28-33.
Review
For citations:
Mashinets N.V., Demidov V.N., Bolmasova A.V., Filippova E.A., Melikyan M.A. Ultrasound in diagnosis of fetal goitrous hypothyroidism (literature review and case report). Ultrasound & Functional Diagnostics. 2017;(2):43-48. (In Russ.)
Views:
62
Email this article 