Therapeutic approach of fetal thyroid disorders

Recent advances in fetal imaging techniques and fetal hormonology allow the identification in the fetus of thyroid function disorders that can potentially be treated in utero by giving drugs to the mother. In women with Graves' disease (when fetal hyperthyroidism is present), it can generally be treated in a noninvasive way by optimizing treatment of the mother. For goitrous nonimmune fetal hypothyroidism leading to hydramnios, intra-amniotic injections of thyroxine have been reported to decrease the size of the fetal thyroid. Experience with such a procedure is limited and the risk of provoking premature labor or infections should be carefully evaluated. Thus, follow-up of the efficacy and the possible long-term undesired consequences of medical interventions administered to the fetus are of great importance. Such interventions should only be performed by specialized teams with extensive experience in perinatal care.