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To the Editor.—
I read with interest in the QUESTIONS AND ANSWERS section (230:1202, 1974) the note entitled "What Risk to Fetus from Maternal Steroid Therapy." A 33-year-old woman had acute thyrotropic exophthalmos with euthyroidism in the fifth month of pregnancy. She required large doses of steroids to control her eye problem, and was given prednisone, 100 mg/day, orally. The question of risks to the fetus was raised, and the follow-up note reported that the patient did have a child who had hydrocephalus requiring surgery at 2 months of age.I should like to point out that this patient was an ideal candidate to have been treated with steroids administered in the sub-tenon space. A single injection of triamcinolone acetonide (Kenalog), 40 mg/ml to both orbits, would have controlled her eye problem for two to six weeks, in my experience, and would have totally obviated the necessity for maintaining her
SMITH JL. The Fetus and Maternal Steroid Therapy. JAMA. 1975;231(9):916. doi:10.1001/jama.1975.03240210012006