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Fetal goiter in the presence of maternal Graves’ disease can signify either hyperthyroidism or hypothyroidism in the fetus. Two patients with Graves’ disease taking propylthiouracil were found to have a fetal goiter on a prenatal sonogram. Fetal blood sampling identified hypothyroidism in both instances. Administration of intraamniotic thyroxine resulted in rapid resolution of the goiter, normalization of subsequent fetal thyroid studies, and delivery of a euthyroid fetus. Cordocentesis allows accurate diagnosis and follow-up of fetal thyroid dysfunction and prompt initiation of appropriate therapy.

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