Antithyroid drug-induced fetal goitrous hypothyroidism

被引:33
作者
Bliddal, Sofie [1 ]
Rasmussen, Ase Krogh [1 ]
Sundberg, Karin [2 ]
Brocks, Vibeke [2 ]
Feldt-Rasmussen, Ulla [1 ]
机构
[1] Copenhagen Univ Hosp, Dept Med Endocrinol, DK-2100 Copenhagen, Denmark
[2] Copenhagen Univ Hosp, Dept Fetal Med & Ultrasound, DK-2100 Copenhagen, Denmark
关键词
THYROID-STIMULATING HORMONE; IN-UTERO TREATMENT; FREE-THYROXINE MEASUREMENTS; MATERNAL GRAVES-DISEASE; EARLY-PREGNANCY; NEONATAL HYPERTHYROIDISM; ANTENATAL DIAGNOSIS; PLACENTAL-TRANSFER; CHILDREN BORN; RISK-FACTOR;
D O I
10.1038/nrendo.2011.34
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T-4 are the most consistent indication of maternal and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T-4 levels.
引用
收藏
页码:396 / 406
页数:11
相关论文
共 115 条
  • [1] Management of thyroid dysfunction during pregnancy and postpartum: An endocrine society clinical practice guideline
    Abalovich, Marcos
    Amino, Nobuyuki
    Barbour, Linda A.
    Cobin, Rhoda H.
    De Groot, Leslie J.
    Glinoer, Daniel
    Mandel, Susan J.
    Stagnaro-Green, Alex
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2007, 92 (08) : S1 - S47
  • [2] Bahn Rebecca S, 2009, Thyroid, V19, P673, DOI 10.1089/thy.2009.0169
  • [3] Baker B, 1989, Thyroidology, V1, P17
  • [4] BALOCH Z, 2002, NACB LAB SUPPORT DIA, P1
  • [5] Choanal atresia associated with maternal hyperthyroidism treated with methimazole:: A case-control study
    Barbero, Pablo
    Valdez, Rita
    Rodriguez, Hugo
    Tiscornia, Carlos
    Mansilla, Enrique
    Allons, Adriana
    Coll, Silvia
    Liascovich, Rosa
    [J]. AMERICAN JOURNAL OF MEDICAL GENETICS PART A, 2008, 146A (18) : 2390 - 2395
  • [6] SONOGRAPHIC FINDINGS IN MATERNAL HYPERTHYROIDISM - FETAL HYPERTHYROIDISM FETAL GOITER
    BELFAR, HL
    FOLEY, TP
    HILL, LM
    KISLAK, S
    [J]. JOURNAL OF ULTRASOUND IN MEDICINE, 1991, 10 (05) : 281 - 284
  • [7] Bellini P, 2000, Minerva Ginecol, V52, P25
  • [8] Delayed Neurobehavioral Development in Children Born to Pregnant Women with Mild Hypothyroxinemia During the First Month of Gestation: The Importance of Early Iodine Supplementation
    Berbel, Pere
    Mestre, Jose Luis
    Santamaria, Asuncion
    Palazon, Inmaculada
    Franco, Ascension
    Graells, Marisa
    Gonzalez-Torga, Antonio
    de Escobar, Gabriella Morreale
    [J]. THYROID, 2009, 19 (05) : 511 - 519
  • [9] Thyroid hormone receptors in brain development and function
    Bernal, Juan
    [J]. NATURE CLINICAL PRACTICE ENDOCRINOLOGY & METABOLISM, 2007, 3 (03): : 249 - 259
  • [10] Graves' Disease in Two Pregnancies Complicated by Fetal Goitrous Hypothyroidism: Successful In Utero Treatment with Levothyroxine
    Blidda, Sofie
    Rasmussen, Ase Krogh
    Sundberg, Karin
    Brocks, Vibeke
    Skovbo, Peter
    Feldt-Rasmussen, Ulla
    [J]. THYROID, 2011, 21 (01) : 75 - 81