Abstract
Fetal hypothyroid goiters are observed in 1:40,000 births. They are usually attributed
to underlying thyroid glandular dysgenesis, dyshormonogenesis, or an adverse effect
of maternal anti-thyroid drugs. The objective of the present case report is to outline
the details of a twin gestation with hypothyroid goiter in both fetuses managed by
intramniotic levothyroxine administration. The index pregnancy was of dichorionic
twin gestation in which the mother was receiving oral propylthiouracil. Fetal goiters
were first detected in ultrasound performed at 31 weeks of gestation. The hypothyroid
nature of goiters was confirmed by cordocentesis from both sacs. Intramniotic administration
of 100 μg of levothyroxine into both sacs was performed twice at the interval of two
weeks. The response to treatment was assessed by amniotic fluid thyroid hormone levels,
and serial measurement of thyroid gland volume. Emergency cesarean section was performed
at 35 weeks due to preterm labor. Both fetuses were euthyroid at birth and were discharged
in good health.
Keywords
Fetal goiter - Fetal hypothyroidism - Intramniotic levothyroxine - Amniocentesis
