Placental Passage of 17-Hydroxycorticosteroids: Comparison of the Levels in Maternal and Fetal Plasma and Effect of Acth and Hydrocortisone Administration 1

Abstract

A progressive rise in the levels of free plasma 17-hydroxycorticosteroids (17-OH-CS) during the course of pregnancy has been observed by a number of investigators (1-4). These findings are in conformity with the increase in urinary glucocorticoids previously reported (5). Normal adult concentrations have been found in the umbilical vein plasma obtained from the newborn infant at the time of delivery (2, 6-8), but significantly lower levels were observed in infants born by cesarean section (7).The site of production and the nature of plasma 17-OH-CS found in increased amounts during pregnancy and at delivery has not yet been elucidated. The maternal and fetal adrenals, as well as the placenta could be the source of C21 steroids with an a-ketolic side chain. A rise in plasma and urinary corticosteroids has been reported in pregnant Addisonian patients (9, 10) which has suggested that during pregnancy an extra-adrenal source, namely the placenta, may be secreting such hormones. The prompt decrease in plasma 17-OH-CS in the newborn infant during the first few days of life (6), and the very low umbilical cord plasma concentrations in infants delivered by cesarean section (7) could be interpreted as indicating a lack of fetal production of corticosteroids.The rather constant ratio of 17-OH-CS in the maternal as compared to the umbilical cord plasma in cases of vaginal delivery has suggested that

The Metabolic Clearance Rate, Blood Production, Interconversion and Transplacental Passage of Cortisol and Cortisone in Pregnancy Near Term

“…It is now well established that cortisol crosses the placenta [22][23][24]. After a pulse injection of 14 G-cortisol in pregnant women at term, radioactivity was found in the cord plasma and amniotic fluid [23].…”

Maternal and fetal plasma levels of free corticosteroids during normal delivery

“…Larger discrepancies have been reported for corticosteroid levels in the umbilical cord. The fact that most authors [4,6,7,8,11] used pooled umbilical cord blood makes a comparison with our results difficult. Considerably higher values were found by KRAUER [7] while other authors [4,11,18] gave somewhat lower values.…”

“…GEMZELL [4] found a constant ratio between the concentration of 17-OH-corticosteroids in the maternal and umbilical blood and assumed that the fetal plasma concentration effected only the conditions in the mother. MIGEON et al [8] postulated a selected placental barrier for 17-OH-corticosteroid but no or only minimal fetal production. In contrast MURPHY and DIEZ o'Aux [11] believe that the increase of corticosteroids in the umbilical artery is caused by an increased fetal production.…”

“…The investigations were carried out in patients and their children fulfilling the following criteria: pregnancies without complications, normal births with spontaneous delivery from occiput anterior Position, delivery between the 38th and 40th weeks of gestation, one minute AP GAR score greater than 8 \-6 cm: EP 1), late first stage (Cervix dilatation 6-10cm: EP 2), second stage of labor (cervix dilatation complete, presenting part on the pelvic floor: AP), during delivery and in the newborn infants 60 and 120 minutes after birth. The blood was drawn in mothers and infants from the anticubital vein.…”

The effect of cortisol on the haematocrit values and serum electrolytes of the adult and foetal rat

“…This was not found in the present study. It is known that in humans although cortisol is actively transported across the placenta, the amount present in the foetal blood is low, compared with the maternal level (Migeon et al 1956). Leyssac (1961) has provided evidence which suggests that the foetal liver rapidly metabolizes any cortisol in the blood, doing so at a much higher rate than the adult liver.…”