Ole L. Myking

Human chorionic gonadotropin and testosterone in normal and preeclamptic pregnancies in relation to fetal sex.

OBJECTIVE The aim of the present study was to evaluate the effects of fetal gender on serum human chorionic gonadotropin (hCG) and testosterone in normotensive and preeclamptic pregnancies. METHODS The study consisted of 137 women with singleton pregnancies in the third trimester. Seventy‐three pregnancies were uncomplicated; among those were 35 male and 38 female fetuses. Sixty‐four pregnancies were complicated by preeclampsia; among those were 33 male and 31 female fetuses. Human chorionic gonadotropin and total testosterone were measured in maternal peripheral blood. RESULTS In male‐bearing pregnancies, maternal hCG and testosterone serum levels were significantly higher in preeclamptic than normotensive mothers (P < .001). In female‐bearing pregnancies, testosterone levels were significantly higher in preeclamptic than normotensive mothers (P < .001), whereas the hCG levels were not significantly different. Male‐bearing preeclamptic women had significantly higher testosterone levels than female‐bearing preeclamptic women (P < .02), whereas the hCG levels were not significantly different. In uncomplicated pregnancies the hCG levels were significantly higher in female‐bearing than in male‐bearing mothers (P < .005), whereas the testosterone levels were not significantly different. CONCLUSION In preeclamptic pregnancies with male fetuses, the maternal serum hCG levels were significantly higher than in uncomplicated pregnancies. Total testosterone levels were significantly higher in pregnancies with either gender and significantly higher in male‐bearing than in female‐bearing pregnancies. This may indicate an androgen influence on the pathophysiologic mechanism of preeclampsia.

Correlation between fetal sex and human chorionic gonadotropin in peripheralmaternal blood and amniotic fluid in second and third trimester normal pregnancies

BACKGROUNDnTo study the correlation between fetal sex and human chorionic gonadotropin (hCG) in maternal blood and amniotic fluid.nnnMETHOD AND MATERIALnOne hundred and thirty uncomplicated pregnancies, 82 of whom were at sixteen and 48 at thirty-five weeks of gestation.nnnRESULTSnThe hCG levels were significantly higher in maternal serum than in amniotic fluid. At 16 weeks there were no sex-related differences in the hCG levels, either in maternal blood or in amniotic fluid. At 35 weeks the hCG levels in maternal blood were significantly higher in pregnancies with female fetuses than in those carrying male fetuses (p<0.004), while in amniotic fluid the hCG levels tended to be slightly higher in the female group than in the male. In pregnancies with female fetuses the hCG levels in maternal blood were significantly higher at 35 than at 16 weeks (p<0.02), while in pregnancies with male fetuses the levels were highest at 16 weeks. For both sexes the hCG levels in amniotic fluid were significantly higher at 16 than at 35 weeks of pregnancy (p<0.001). Whereas a significant correlation between hCG levels in maternal blood and amniotic fluid was seen at 16 weeks of gestation for both sexes (p<0.01 and R value 0.45 for males and 0.41 for females), no correlation was observed at 35 weeks.nnnCONCLUSIONnThis study shows a significant correlation between hCG and fetal sex at third trimester of gestation only, possibly caused by a gender factor and a shift in synthesis and/or in metabolism of hCG from the second to the third trimester.

Human chorionic gonadotropin in maternal serum in relation to fetal gender and utero‐placental blood flow

Background.u2002 To investigate whether fetal gender differences in human chorionic gonadotropin (hCG) in maternal serum and the presence of hCG receptors in the wall of the uterine arteries influence the utero‐placental blood flow.

The Glucose Oxidation in Isolated Leukocytes from Female Patients Suffering from Overweight or Anorexia Nervosa

Leukocytes from controls and patients with either overweight or anorexia nervosa were incubated with [U-14C]glucose in buffer with or without 50 percent serum. The production of [14C]O2 was measured both under phagocytosing and nonphagocytosing conditions. On the average leukocytes from the two groups of patients produced less [14C]O2 than leukocytes from the controls. Sera from controls stimulated the glucose oxidation in control leukocytes more than sera from patients with anorexia nervosa and less than sera from overweight patients. Neither the insulin nor the glucose content of the sera was of importance for the results. We assume that other serum factors may contribute to the reduced glucose oxidation in leukocytes from patients with anorexia nervosa, whereas this is not the case for patients with overweight.

Role of angiotensin II under prolonged increased intraabdominal pressure (IAP) in pigs

Background: The aim of the study was to investigate the effect of the angiotensin II receptor antagonist losartan on renal hemodynamics and diuresis in pigs with increased intraabdominal pressure (IAP). Methods: The IAP was maintained at 30 mmHg for 3 h by intraperitoneal instillation of Ringer’s solution. Ten animals were treated with losartan; another 10 animals served as controls. Renal blood flow, hormones in renal vein blood, and diuresis were measured. Results: In control animals, the renal vascular resistance increased renal blood flow remained constant, the blood concentration of aldosterone increased and the diuresis decreased during increased IAP. Losartan prevented the increase in vascular resistance and improved renal blood flow under increased IAP. It also prevented the rise in aldosterone concentration and increased the urine output to baseline level. Conclusion: Our results suggest that the renal vasoconstriction associated with increased IAP is due to increased production of angiotensin II. The oliguria associated with increased IAP is probably due, at least partly, to increased reabsorbtion of sodium and water in the renal tubuli caused by increased tissue concentration of aldosterone.

Medical abortion in the first trimester: the use of serum hCG and endometrial thickness as markers of completeness.

Objective The combination of mifepristone and misoprostol is an established method for induction of early first trimester abortion, but there is no consensus about the best evaluation of treatment outcome. We assessed endometrial thickness, determined by ultrasound and serum-human chorionic gonadotropin (s-hCG) as markers of successful management. Methods Prospective trial involving 255 women, with a gestation of 62 days or less, who were to undergo medical abortion. In addition to our established routines of performing clinical and ultrasound examinations, we also determined the s-hCG level prior to treatment and at follow-up. Results Of the 255 subjects treated during the study, 20 (7.8%) were lost to follow-up. The overall complete abortion rate was 94.0%. Fourteen subjects required vacuum aspiration, nine of them prior to the scheduled follow-up and five thereafter. None of the pregnancies were ongoing. A decrease of 99% in s-hCG levels was noted in 99% of the women, when levels determined prior to mifepristone intake and those measured 15–71 days post-abortion were compared. Conclusion This study confirms that s-hCG levels drop sharply after medical abortion. To assess the completeness of medical abortion, we recommend that clinical examination to be combined with determination of s-hCG. Ultrasonography should be carried out only when indicated.

Effects of the Endothelin-1 Receptor Antagonist Tezosentan on Renal Blood Flow and Diuresis During Prolonged Increased Intra-abdominal Pressure

BACKGROUNDnIt has earlier been shown that increased intra-abdominal pressure (IAP) reduces renal blood circulation and urine output both clinically and experimentally. The aim of this study was to investigate the effect of endothelin-1 inhibition by the endothelin-1 receptor antagonist tezosentan on renal blood circulation and diuresis in pigs subjected to prolonged increased intra-abdominal pressure.nnnMATERIAL AND METHODSnThe IAP in domestic pigs was maintained at 30 mmHg for 3 h. One group of 10 animals was pre-treated with the endothelin-1 receptor antagonist tezosentan, and then received continuous infusion of tezosentan throughout the experiment. Another group of 10 animals served as control. We measured renal cortex blood flow, plasma renin activity, blood concentrations of endothelin-1 and aldosterone, and diuresis.nnnRESULTSnThe administration of tezosentan to pigs with an IAP of 30 mmHg was followed by reduced arterial pressure, reduced renal cortex blood flow, and reduced diuresis. The plasma renin activity increased markedly, but neither renal vascular resistance nor blood concentration of aldosterone did change significantly.nnnCONCLUSIONnTezosentan reduced the arterial blood pressure, which resulted in decreased renal cortex blood flow, and aggravation of the oliguria usually observed under increased IAP. The plasma renin activity increased, but this was not followed by changes in renal vascular resistance, or blood concentration of aldosterone. The results indicate that drugs, which reduce the arterial pressure, may be harmful to the kidneys under increased IAP.