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  • Title: [Amniotic fluid cortisol, tetrahydrocortisone, estriol and estetrol in normal and high risk pregnancy (author's transl)].
    Author: Izumi M.
    Journal: Nihon Sanka Fujinka Gakkai Zasshi; 1981 Aug; 33(8):1245-54. PubMed ID: 7276651.
    Abstract:
    In order to determine the possibility of assessing intrauterine fetal well being by measuring amniotic fluid steroid levels, a number of selected glucocorticoids and estrogens were assayed. Estriol (E3) and estetrol (E4) levels at 36-40 weeks of pregnancy, especially that of total E3 (T-E3 and unconjugated E4 (U-E4) rose significantly (p less than 0.01), and were at a ratio of T-E3/U-E3 8; T-E4/U-E4 2, respectively. A definite correlation was found between T-E3 and U-E3 (r = 0.97) which was not detected in the case of E4, and there was a high correlation with umbilical arterial levels of both unconjugated and total E3 and E4. Amniotic fluid cortisol (F) levels in both unconjugated (U-F) and sulfate conjugated (S-F) rose preferentially at 36-40 weeks and exceeded the levels of both umbilical arterial and maternal peripheral plasma (p less than 0.01). Both tetrahydro-cortisone (THE) and -cortisol (THF) levels increased at 29-35 weeks which in the select cases were comparable with the increases seen at 36-40 weeks. The THE level showed a definite correlation with that of umbilical artery (r = 0.73) whereas this was not the case for S-F. In pregnancies complicated with toxemia and/or diabetes mellitus, T-E3 and S-F levels are less than the lower limits for normal pregnancies. This tendency was not observed with T-E4 and THE. In pregnancies with severe RH isoimmunization, the levels of T-E3, T-E4 and S-F are markedly lower than those seen in normal pregnancies, and do not display the increase with gestational advances. On the other hand, THE and THF levels were shown to be at levels higher than in normal pregnancies. Thus, in the latter half of pregnancy, amniotic fluid steroid assays, especially T-E3, S-F and THE may be of use in the assessment of fetal well being.
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