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Amniotic Fluid Concentrations of Iodothyronines and Thyrotropin Do Not Reliably Predict Fetal Thyroid Status in Pregnancies Complicated by Maternal Thyroid Disorders or Anencephaly^*

Departments of Reproductive Medicine and Pathology, University of California San Diego, California

Address requests for reprints to: Dr. Dorothy R. Hollingsworth, Department of Reproductive Medicine (T-002), University of California, San Diego, La Jolla, California 92093.

In this study we report measurements of amniotic fluid (AF) concentrations of iodothyronines and TSH in 69 normal and 16 complicated pregnancies. The latter group included 2 women with untreated hyperthyroidism, 1 patient with untreated hypothyroidism, 5 hyperthyroid patients who received propylthiouracil (3 with Graves' disease, 1 with a multinodular goiter, and 1 with chronic thyroiditis), 3 women with Graves' disease who were hypothyroid after treatment, but who were receiving replacement therapy, and 5 anencephalic pregnancies. AF hormone levels could not be correlated with either maternal or cord serum values, neonatal serum measurements, and/or the clinical status of the infant. AF TSH and T₄ levels were markedly elevated in 1 patient with Graves' disease and severe Rh isoimmunization and in 2 pregnancies complicated by anencephaly without identifiable pituitary tissue in the fetus. We conclude that measurements of AF concentrations of thyroid hormones and TSH do not reliably predict fetal or neonatal thyroid status.

^* Presented in part at the 57th Annual Meeting of the American Thyroid Association, Minneapolis, MN 1981.

Received December 15, 1982.

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