Abstract
Hyperthyroidism can manifest very early in fetal life (fetal thyrotoxicosis) or immediately after birth (neonatal thyrotoxicosis). The authors describe outcome of pregnancies in a woman with Graves’ disease who received medical management and underwent subtotal thyroidectomy. The first pregnancy resulted in macerated stillbirth at 32 wk. Fetal tachycardia was followed by intrauterine death at 30 wk in the second pregnancy and macerated stillbirth at 26 wk in the third pregnancy. Fetal tachycardia was detected at 17 wk in the fourth pregnancy. Treatment with carbimazole along with thyroxine was followed by a live birth at 35 wk; but the baby developed severe fatal neonatal thyrotoxicosis with crisis on day 9 and died on day 12. Fetal tachycardia was noted in the fifth pregnancy as well and she was treated with carbimazole and thyroxine. She delivered a male baby at 37 wk. He developed neonatal hypothyroidism on day 8 which was controlled with thyroxine.
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References
Ogilvy-Stuart AL. Neonatal thyroid disorders. Arch Dis Child Fetal Neonatal Ed. 2002;87:F165–71.
Abalovich M, Amino N, Barbour LA, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2007;92:S1–47.
Weetman AP. Graves’ disease. N Engl J Med. 2000;343:1236–48.
Barbesino G, Tomer Y. Clinical utility of TSH receptor antibodies. J Clin Endocrinol Metab. 2013;98:2247–56.
Batra CM. Fetal and neonatal thyrotoxicosis. Indian J Endocrinol Metab. 2013;17:S50–4.
Tagami T, Hagiwara H, Kimura T, Usui T, Shimatsu A, Naruse M. The incidence of gestational hyperthyroidism and postpartum thyroiditis in treated patients with Graves’ disease. Thyroid. 2007;17:767–72.
Hamada N, Momotani N, Ishikawa N, et al. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism. Endocr J. 2011;58:55–8.
Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract. 2011;17:456–520.
Fisher DA. Fetal thyroid function: diagnosis and management of fetal thyroid disorders. Clin Obstet Gynecol. 1997;40:16–31.
De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2012;97:2543–65.
Acknowledgments
The authors acknowledge the contribution of Dr Veera Hingorani who was the Head of Department of Obstetrics and Gynecology, Batra Hospital at that time. She did the complete obstetrical management of the patient and referred her to the authors. She has not been listed as an author as she is not able to read and sign the manuscript.
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All the authors contributed equally in this paper. Dr. PSN Menon will act as guarantor for this paper.
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Batra, C.M., Gupta, V., Gupta, N. et al. Fetal Hyperthyroidism: Intrauterine Treatment with Carbimazole in Two Siblings. Indian J Pediatr 82, 962–964 (2015). https://doi.org/10.1007/s12098-015-1744-0
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DOI: https://doi.org/10.1007/s12098-015-1744-0