Patient was counseled in detail.Patient’s thyroid function test was done – Severe hypothyroidism (Serum TSH 75 noted)Cordocentesis was done – Fetal TSH more than 400 mcg was noted.Ideally in utero injection Levothyroxine is indicated. Unfortunately it was not available at all major centers in India where I inquired. Endocrinologist was consulted. Alternatively, it was suggested to give high dose of maternal Thyroxine (400mcgm / day for 3 days) with explanation & risk of thyroid crisis. Crash therapy-Acute suppression therapy was given twice, week apart. Patient responded well. Polyhydamnios turned back to less than 20 cm.Size of thyroid gland almost became normal.
At term, 2.7 kg baby, male child was delivered. Immediate & 1 weeks serum TSH, Free T3, T4 level were normal.