Intrapartum labetalol for the treatment of maternal and fetal thyrotoxicosis

Maternal thyrotoxicosis complicates approximately 0.2% of pregnancies. Simultaneous occurrence of maternal and fetal thyrotoxicosis during labor is rare, and control of maternal tachycardia and hypertension, as well as fetal manifestations of thyrotoxicosis, are cornerstones of management. An 18- year-old nulliparous female at 33 weeks gestational age presented in labor with thyrotoxicosis. Fetal tachycardia was present as well. Labetalol therapy resulted in a decrease in maternal pulse and blood pressure, and resolution of fetal tachycardia. Vaginal delivery occurred. Subsequent evaluation demonstrated neonatal thyrotoxicosis and high maternal titers of thyroid- stimulating immunoglobulin. In conclusion, labetalol was beneficial in the treatment of maternal and fetal thyrotoxicosis during labor.