Tadashi Uesato

Increased Serum Ca 125 Levels During the First Trimester of Pregnancy

An immunoradiometric assay for an ovarian tumor associated antigen (CA 125) has recently been developed. the CA 125 assay was reported to be fairly sensitive for ovarian cancer. However, elevated CA 125 levels were reportedly observed in 1% of healthy controls, 6% of patients with miscellaneous diseases and 29% of patients with non‐gynecological cancer. Therefore, the specificity of the CA 125 assay must be evaluated before its wide clinical application. Furthermore, data on the CA 125 levels in pregnant women have not heretofore been reported. in the present study, CA 125 levels were determined in sera randomly obtained from normal, pregnant women at various weeks of pregnancy and in sera serially collected from women who achieved pregnancy after ovulation induction. When compared with the normal, non‐pregnant state, CA 125 levels in pregnant women were significantly higher during the first trimester, but not during the second and third trimesters. Although CA 125 levels in women during the first trimester of pregnancy were significantly lower than those in patients with ovarian cancer, there was a considerable overlap between them. CA 125 levels were undetectable before pregnancy in all of the 8 patients who achieved pregnancy after ovulation induction. They rose during the first trimester of pregnancy in 7 of the 8 patients, and they decreased thereafter to undetectable levels by the end of the first trimester. the increased CA 125 level in the early pregnancy provides an important information for the clinical application of the CA 125 assay. Pregnancy should be ruled out when increased CA 125 levels are found in women during the childbearing years.

Serum relaxin and steroid hormones in spontaneous abortions

To assess the capacity of the corpus luteum to secrete steroid hormones and relaxin during spontaneous abortion, human chorionic gonadotropin (hCG), progesterone, 17α‐hydroxyprogesterone (17‐OHP) and relaxin concentrations were determined in serum samples obtained from 16 spontaneously aborting first‐trimester patients and 5 asymptomatic, apparently normal women who subsequently aborted. hCG and P were subnormal in more than half of aborting patients, and 17‐OHP in half of them. However, relaxin was normal in most of them. No patient with subnormal relaxin levels had hCG values in the normal range. Such a relationship was not found between hCG and 17‐OHP values. Hence, decreases in placental activity seem to precede a decrease in luteal ability to secrete relaxin but not to secrete stereoid hormones. Some aborting patients with subnormal 17‐OHP levels had normal relaxin values. All but 1 woman who aborted subsequently had subnormal 17‐OHP values at a time when relaxin levels were normal. Therefore, in some aborting patients, the ability of the corpus luteum to secrete steroid hormones is impaired at a time when its capacity to secrete relaxin is preserved.

Comparison of plasma oxytocin levels during spontaneous labor and labor induced by amniotomy, prostaglandin F2α, and prostaglandin E2

Plasma concentrations of oxytocin in nine spontaneous labors (group 1), nine amniotomy-induced labors (group 2), six prostaglandin F2 alpha-induced labors (group 3), and five prostaglandin E2-induced labors (group 4) were determined at the stages of 1 to 7 days preceding the onset of labor, onset of labor, and established labor, by means of unextracted radioimmunoassay. The levels of oxytocin in the stage preceding the onset of labor in group 1 were not significantly different from the levels of oxytocin in the corresponding stages in groups 2, 3, and 4. However, the levels of oxytocin in the stages of onset of labor and established labor in group 1 were significantly higher than those in the corresponding stages in groups 2, 3, and 4. These results suggest that oxytocin plays a leading role in the onset and progress of spontaneous labor, whereas something other than oxytocin might be involved in the labor induced by amniotomy alone or by prostaglandins.

Serum relaxin concentrations in women following the administration of 16,16-dimethyl-trans-Δ2-PGE1 methyl ester during early pregnancy

Serum relaxin was estimated in 11 women during termination of first-trimester pregnancy with 16,16-dimethyl-trans-delta 2-PGE1 methyl ester (16 DM-PGE1). Vaginal administration of 16 DM-PGE1 was associated with a significant increase in serum relaxin.