ASSESSMENT OF PLACENTAL FUNCTION IN UNCOMPLICATED AND COMPLICATED LATE PREGNANCY BY ESTIMATION OF UNCONJUGATED OESTROGENS IN PLASMA AFTER AN INTRAVENOUS INJECTION OF DEHYDROEPIANDROSTERONE SULPHATE

Abstract

ABSTRACT An intravenous injection of 50 mg dehydroepiandrosterone sulphate (DHAS) was given to 60 women in late pregnancy. Following the injection, the plasma concentration of unconjugated oestradiol, oestrone and oestriol was measured at intervals. Radioimmunoassays were used for the estimation of the plasma oestrogens. In women with uncomplicated pregnancies a rapid and pronounced rise was found for plasma oestradiol. No significant changes in the oestradiol response were observed with advancing gestational age from the 32nd to the 40th week of pregnancy. Patients with pre-eclampsia or intrauterine growth retardation (IUGR) showed a lower increase and a later appearance of the peak value. The oestradiol response in diabetic women was similar to that in women with normal pregnancies. The concentration of plasma oestrone rose more slowly and to a minor degree than did oestradiol. No changes were found in the oestrone response with advancing gestational age. In women with preeclampsia and IUGR a lower increase and a later appearance of the maximum level was observed. The oestrone response in diabetic women was indistinguishable from that in women with normal pregnancies. No changes could be detected in the plasma concentration of unconjugated oestriol after the DHAS injection. It is concluded that the great spread in the oestrogenic response limits the clinical usefulness for assessing placental function. However, in women with low basal values of oestriol in urine or plasma the test may be helpful for diagnosing placental insufficiency.