CASE 6: ANTENATAL USG

25F female. Antenatal Scan, known hypothyroid

Findings reveal

Echogenic lesion in the neck extending inferior to the superior mediastinum.

DIAGNOSIS

FETAL GOITER

RADPEARLS

Can be seen in fetuses with hypothyroid mothers especially those who stop taking their medication during pregnancy

Seen as an echogenic lesion in the neck

Complications include : polyhydramnios due to esophageal and tracheal compression, both of which may be compounded by neck hyperextension leading to dystocia

Respiratory impairment can also occur because of compression of the trachea by the enlarged thyroid gland

Diagnosis is by Fetal Cord Blood Sampling / Amniocentesis

Treatment can include weekly intra-amniotic injections of thyroid hormone after measuring TSH, T4 of amniotic fluid

Further Reading

Case Contribution: Dr Balkrishna Kitture, Kolhapur, IN