e-ISSN:2147-2181 Hydrops Fetalis Secondary to Maternal Exposure to Propylthiouracil Maternal Propiltiourasil Maruziyet Sonrası Gelişen Fetal Hidrops Endokrinoloji ve Metabolizma Başvuru: 06.04.2015 Kabul: 25.05.2015 Yayın: 23.06.2015 Oğuzhan Aksu 1 , Bünyamin Aydın 1 , Seyit Ali Köse 1 , Banu Kale 1 , Mehmet Numan Tamer 1 1 Süleyman Demirel Üniversitesi Tıp Fakültesi Özet Tiroid hastalıkları, gebelik esnasında kompleks hormonal değişiklikler nedeniyle yaygın olarak görülür. Fetal hidrops, düşük doğum ağırlığı, fetal distress ve nörofizyolojik gelişme geriliği açısından risklidir. 20 yaşında primigravid gebe hipotiroidizmle başvurdu ve bu esnada propiltiourasil (PTU) 3x1 kullanmaktaydı. Yapılan ultrasonografi (USG)’de hidrops fetalis görüldü ve bunun üzerine PTU tedavisi kesildi. Takiplerinde fT3 2.81 (2.3-4.2) pg/ml, fT4 0.82 (0.88-1.72)ng/dl ve TSH 1.65 (0.57-5.6) μIU/ml olarak tespit edildi. Kontrol US’de fetal hidropsta gerileme olduğu görüldü. Hasta 37+2 haftalık iken sezeryan ile 3150 gr ağırlığında bir kız çocuğu dünyaya getirdi. Abstract Thyroid disorders are common in pregnancy, due to the complex hormonal changes during pregnancy. Fetal hypothyroidism has been associated with increased risk of low birth weight, fetal distress, and impaired neuropsychological development. A 20-year- old primigravida had no pregnancy-related problem but had hypothyroidism. Propylthiouracyl (PTU) 3x1 had been commenced, on that control visit, ultrasonography (US) revealed hydropsfetalis, and the patient has been referred to our policlinic. We discontinued PTU and on her control visit, fT3 was 2.81 (2.3-4.2) pg/ml, fT4 was 0.82 (0.88-1.72) ng/dl, and TSH was 1.65 (0.57-5.6) μIU/ml; control US revealed regression of fetal hydrops. A normal-birth- weight (3150 gr) female infant born (a cesarean section was performed) at 37+2 weeks’gestational age. Anahtar kelimeler: Fetal Hidrops, Propilthiourasil Keywords: Hydrops Fetalis, Propylthiouracil Introduction Thyroid hormones are essential for fetal neurological development 1 . Fetal hypothyroidism may result from maternal exposure to anti-thyroid drugs (ATD) 2 . Intra-amniotic treatment with levothyroxine normalizes fetal thyroid functions and reduces size of goiter. Fetal hypothyroidism is an uncommon condition in the etiology of hydropsfetalis. Maternal exposure to ATD may additionally lead to congenital anomalies of musculoskeletal system and urogenital system. Herein, we present a pregnant woman with hydropsfetalis secondary to maternal exposure to high-dose propylthiouracil. Case Report A 20-year-old primigravida consults her physician for routine control in the 12 th week of first gestation. Meanwhile, she mentions about sweatcomplaint existing for the last one year. Results of laboratory analyses performed accordingly were as follows: free T3:3.76 (2.5-3.9) pg/ml, free T4:1.18 (0.61-1.12) ng/dl,and TSH:0.42 (0.34-5.6) μIU/ml. The patient had been told that she had no pregnancy-related problem but had hypothyroidism. Propylthiouracyl (PTU) 100 mg/day had been commenced and she had been asked to come for control visit after one month. On the control visit after one month, she had been informed that there was no Sorumlu Yazar: Bünyamin Aydın, Süleyman Demirel Üniversitesi Tıp Fakültesi Süleyman Demirel Üniversitesi Tıp Fakültesi, Çünür aydinbunyamin@yahoo.com CausaPedia 2015;4:1239 Sayfa 1/4