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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(04): 317-322
DOI: 10.1055/s-0041-1729143
Case Report

Excessive Prenatal Supplementation of Iodine and Fetal Goiter: Report of Two Cases Using Three-dimensional Ultrasound and Magnetic Resonance Imaging

Suplementação pré-natal excessiva de iodo e bócio fetal: Relato de dois casos utilizando ultrassonografia tridimensional e ressonância magnética
Pedro Castro 
1   Department of Fetal Medicine, Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ, Brazil
2   Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Heron Werner 
1   Department of Fetal Medicine, Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ, Brazil
,
Paulo Roberto Silva Marinho 
3   Department of Obstetrics and Gynecology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Ana Paula Matos 
1   Department of Fetal Medicine, Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ, Brazil
,
Pedro Pires 
4   Department of Obstetrics and Gynecology, Universidade de Pernambuco, Recife, PE, Brazil
,
Edward Araujo Júnior 
5   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
6   Medical course, Universidade Municipal de São Caetano do Sul, São Paulo, SP, Brazil
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Abstract

Fetal thyroid complications in pregnancy are uncommon, and are commonly related to the passage of substances through the placenta. The excessive iodine intake during the pregnancy is a well-known mechanism of fetal thyroid enlargement or goiter, and invasive procedures have been proposed for the treatment of fetal thyroid pathologies. In the present report, we demonstrate two cases from different centers of prenatal diagnosis of fetal thyroid enlargement and/or goiter in three fetuses (one pair of twins, wherein both fetuses were affected, and one singleton pregnancy). The anamnesis revealed the ingestion of iodine by the patients, prescribed from inadequate vitamin supplementation. In both cases, the cessation of iodine supplement intake resulted in a marked reduction of the volume of the fetal thyroid glands, demonstrating that conservative treatment may be an option in those cases. Also, clinicians must be aware that patients may be exposed to harmful dosages or substances during pregnancy.

Resumo

As complicações fetais da tireoide na gravidez são incomuns e são comumente relacionadas à passagem de substâncias pela placenta. A ingestão excessiva de iodo durante a gravidez é um mecanismo bem conhecido de aumento da tireoide ou bócio fetal, e procedimentos invasivos foram propostos para o tratamento de patologias da tireoide fetal. No presente relato de caso, demonstramos dois casos de diferentes centros de diagnóstico pré-natal de aumento da tireoide fetal e/ou bócio em três fetos (um par de gêmeos, em que ambos os fetos foram afetados, e uma gravidez única). A anamnese revelou a ingestão de iodo pelos pacientes prescrita por suplementação inadequada de vitaminas. Nos dois casos, a interrupção da ingestão de suplemento de iodo resultou em uma redução acentuada do volume das glândulas tireoides fetais, demonstrando que o tratamento conservador pode ser uma opção nestes casos. Além disso, os médicos devem estar cientes de que as pacientes podem ser expostas a doses ou substâncias nocivas durante a gravidez.

Keywords

fetal goiter - prenatal care - iodine supplementation - three-dimensional ultrasound - magnetic resonance imaging

Palavras-chave

bócio fetal - atenção pré-natal - suplementação de iodo - ultrassonografia tridimensional - ressonância magnética


Publication History

Received: 18 February 2020

Accepted: 02 February 2021

Article published online:
12 May 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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