A Case Report on Fetal Goiter: Management and treatment by Ultrasound Diagnosis

Abstract

Fetal goiter is a rare condition characterized by abnormal enlargement of the fetal thyroid gland and can be associated with hypo- or hyperthyroidism. This article presents the case of a 27-year-old patient with a history of Graves’ disease, with her last thyroid function test with elevated T3 in blood, T4 within normal ranges and a lowered TSH and anti-thyroid hormone intake (Propylthiouracil) during the first trimester, unaware of her pregnancy. At 29.3 weeks of gestation, an ultrasound revealed a heterogeneous mass in the fetal neck with peripheral vascularity, consistent with fetal goiter. Growth restriction was also noted, the case was followed up by two endocrinologists, but, for economic reasons, the patient forfeits the treatment within two weeks of the beginning. Fetal goiter is a rare condition, seen in 1 of 50,000 of newborns, The main causes include genetic mutations, maternal autoimmune conditions, and the use of antithyroid drugs during pregnancy. This condition can severely impair fetal development, leading to mechanical complications (such as asphyxia) and metabolic abnormalities (such as mental retardation or heart failure). Prenatal diagnosis through ultrasound is essential, as it allows early treatment planning and prevents severe neonatal complications. The study concludes that obstetric ultrasound plays a vital role in the early detection of fetal goiter and associated malformations. Accurate evaluation can guide therapeutic interventions and minimize risks during pregnancy and delivery.