THE EXCRETION OF OESTRIOL AND OF PREGNANEDIOL IN PREGNANCY COMPLICATED BY Rh IMMUNIZATION

High oestrogen excretion in pregnancy

“…Oestriol excretion does correlate with fetal adrenal weight (Frandsen 1963) and normal fetal adrenals can compensate sufficiently for absence of maternal adrenals to produce oestrogens in the normal range (Charles et al 1971). Hyperplastic adrenals are present in some fetuses with severe Rhesus isoimmunization (Potter & Craig 1976) and high oestriol excretion is often associated with this condition even when fetus and placenta are not heavy (Klopper & Stephenson 1966). A direct association with oestrogen excretion above the 95th centile has been shown in one fetus with adrenocortical hyperplasia (Cathro et al 1969).…”

Amniotic and Urinary Oestriol Assays in Pregnancies Complicated by Rhesus Immunization

“…IN the search for a reliable method of assessing fetal well-being in pregnancies complicated by rhesus immunization, several studies of hormones in maternal urine, blood and amniotic fluid have been reported (McCarthy and Pennington, 1964a and b;Klopper and Stephenson, 1966;Schindler et al, 1967;Bjerre et al, 1968;Dickey et al, 1968;Aleem et al, 1969;Berle, 1969). The measurement of hormones or metabolites of solely placental origin is unlikely to be helpful in this respect as the placenta in haemolytic disease of the fetus and newborn may be large and hydropic, and capable of producing greater than normal amounts of these hormones (McCarthy and Pennington, 1964a and b;Klopper and Stephenson, 1966;Berle, 1969).…”

Observations on the Role of the Fetal Adrenal Gland in Steroidogenesis During Diabetic Pregnancy

“…That the fetal adrenal gland is important in this connection is indicated by the fact that the amounts of urinary oestriol excreted by the mother in late pregnancy tend to be abnormally low in the presence of anencephaly, a condition in which marked hypoplasia of this gland is a feature Stakemann, 1963, 1964). Furthermore, fetal death in utero is generally associated with a marked fall in maternal urinary oestrogen levels, while in cases in which fetal growth is retarded the rate of oestriol output is subnormal (Greene et al, 1962;Klopper and Stephenson, 1966;Macnaughton, 1967). The fact that the maternal adrenal gland is also of importance is indicated by the low urinary oestrogen readings characteristic of pregnant women with Addison's disease and of patients who become pregnant following bilateral adrenalectomy (Charles et al, 1970b).…”