The Human Placenta and Membranes: A Histological and Immunofluorescent Study of the Effects of Intra‐amniotic Injection of Hypertonic Saline

Urinary Excretion of Oestriol and Pregnanediol During Bougie-Induced Abortion in Mid-Pregnancy

“…Bengtsson & Csapo (1962) state that the uterus starts vigorous contractions when it is freed from the restraining influence of placental progesterone, and Bengtsson & Stormby (1962) noted extensive damage^of the placenta delivered by this method. Other investigators, however, have found placental damage from saline to be slight (Christie et al 1966), with no significant change in urinary output of pregnanediol during this treatment (Klopper et al 1966). Several investigators have noted that the oestriol levels in urine decrease markedly (Wagner, Frandsen & Stakemann, 1963;Klopper et al 1966).…”

“…Several investigators have noted that the oestriol levels in urine decrease markedly (Wagner, Frandsen & Stakemann, 1963;Klopper et al 1966). In any case, the foetus dies shortly after the injection of hypertonic saline, and it is reasonable to assume that some changes occur in the foeto-placental unit during abortion by this method (Wagner et al 1963 ;Klopper et al 1966;Christie et al 1966).…”

“…Some investigators think that this method damages the placenta and that the resulting withdrawal of the restraining effect of progesterone precipitates uterine contractions (Bengtsson & Csapo, 1962;Bengtsson & Stormby, 1962). Others failed to find evidence supporting this hypothesis (Klopper, Turnbull & Anderson, 1966;Christie, Anderson, Turnbull & Beck, 1966).…”

On the Mechanism of Action of Intra-Amniotic Hypertonic Saline Treatment in Rabbits

“…Csapo (1961) suggested that the abortion is produced by a reduction in progesterone secretion consequent upon structural damage to the placenta caused by the saline. However, claims that extensive necrosis of the placenta follows intra-amniotic hypertonic saline administration (Csapo & Lloyd-Jacob, 1962; Bengtsson Straus, 1963;Wynn, 1965;Friedrich, personal communication) have been contested (Christie, Anderson, Turnbull & Beck, 1966). Furthermore, whereas the steroid chemical analyses of Wiest, Kerenyi & Csapo (1966) and Wiest (1967) document that a fall in blood-progesterone occurs following intra-amniotic saline, those of Short, Wagner, Fuchs & Fuchs (1965), Kerr, Roy, Harkness, Short & Baird (1966) and Klopper, Turnbull & Anderson (1966) do not support this hypothesis.…”

Hormones and Metabolism in Pregnancy

“…Usually, however, these abortions must occur despite a great excess of progesterone relative to oestrogen. Christie, Anderson, Turnbull and Beck (1966) have shown that placental damage is limited to a thin sulbchorionic layer (amounting at most to 15 per cent of placental thickness) in which there is intervillous thrombosis and necrosis of villi. In the remaining 85 per cent or more of the placenta which was histologically normal, new im,munofluorescent techniques indicated normal concentration of placental growth hormone and of steroids within the syncytiotrophoblast, in keeping with nortnal function.…”