Conservative in utero treatment of fetal dyshormonogenetic goiter with levothyroxine, a systematic literature review
- Dragos Nemescu
- Ingrid Andrada Tanasa
- Dana Liana Stoian
- Dan Bogdan Navolan
- Angela Elena Vinturache
Affiliations: Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy,700115 Iasi, Romania, Department of Endocrinology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania, Department of Obstetrics and Gynecology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania, Department of Obstetrics and Gynecology, Queen Elizabeth II Hospital, Grande Prairie, AB T8V 2E8, Canada
- Published online on: May 26, 2020 https://doi.org/10.3892/etm.2020.8794
Copyright: © Nemescu
et al. This is an open access article distributed under the
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Fetal goitrous hypothyroidism is a rare condition associated with important obstetrical, neonatal complications, and neurodevelopmental impairments. Prenatal treatment remains controversial, and the risk to benefit ratio must be accurately assessed and considered for individualized management. The objective of this review was to evaluate the feasibility, safety, and effectiveness of the conservative in utero treatment of fetal goitrous hypothyroidism. In total, 25 reports that met our inclusion criteria were selected and the management of 38 cases was analyzed. Prenatal diagnosis consisted mainly of ultrasonographic findings. Fetal thyroid status was assessed by cordocentesis. Prenatal treatment varied widely in terms of levothyroxine (LT4) route of administration, dosage, number of injections, and frequency. Although different regimens and routes of administration were proposed, they seem to have similar results regarding fetal goiter reduction and thyroid status at birth. At birth, most babies had hypothyroidism, but the long‑term follow‑up indicated a normal psycho‑neuromotor development. Our data confirm the feasibility of conservative treatment with LT4 for fetal goitrous hypothyroidism. Further studies are needed to determine the optimal management of this disorder.