William J. Dignam

Neutral C19-steroids and steroid sulfates in human pregnancy II. Dehydroepiandrosterone sulfate, 16α-hydroxydehydroepi-androsterone, and 16α-hydroxydehydroepiandrosterone sulfate in maternal and fetal blood of pregnancies with anenphalic and normal fetuses

Abstract Dehydroepiandrosterone sulfate (DS), 16α-hydroxydehydroepiandrosterone sulfate (16α-OH-DS) and 16α-hydroxydehydroepiandrosterone (16α-OH-D) were measured in cord plasma of five anencephalic fetuses with histologically proven hypoplasia of the fetal zone of the adrenal cortex. DS was determined by the Zimmermann reaction on paper as described previously by us, the 16α-hydroxylated compounds by a modification of the method of Katz. These hormones were also measured in antecubital venous blood of the mothers of these fetuses. For comparison normal pregnant women and normal fetuses were studied. Neither 16α-OH-D nor 16α-OH-DS could be detected in peripheral blood of mothers bearing anencephalic or normal fetuses. In the former group, all DS levels (M±s = 93±31 μg%) were within the normal range. 16α-OH-D, 16α-OH-DS, or DS could not be detected in the cord plasm of anencephalic fetuses. If these steroids were present, their concentrations (

Neutral C19-steroids amd steroid sulfates im human pregnancy I. Identification op dehydroepiandrosterone sulfate in fetal blood and quantification of this hormone in cord arterial, cord venous and maternal peripheral blood in normal pregnancies at term

Abstract Identification of dehydroepiandrosterone sulfate (DS), in umbilical cord blood is presented. Utilizing a modification of the method of McKenna, DS was measured as the sulfate in maternal vein and umbilical artery and vein of 20 normal cases. Reliability criteria of the method are given. Mean concentration and standard deviation of plasma DS were found to be 100.00 ± 52.0 μg % for maternal peripheral vein, 162.0 ± 62.5 μg % for cord artery, and 130.5 ± 59.5 μg % for cord vein. The values were corrected for losses. An arteriovenous difference of 31.5 μg % in the cord plasma suggests an uptake of DS by the placenta and its probable production in the fetus. Calculating the values as μg DS % whole blood on the basis of the individual hematocrits, there was no significant difference between maternal venous blood and cord arterial or venous blood.

Neutral C19-steroids and steroid sulfates in human pregnancy II. Dehydroepiandrosterone sulfate, 16α-hydroxyderhydroepiandrosterone, and 16α-hydrosydehydroepiandrosterone sulfate in cord blood and blood of pregnant women with and without treatment with corticoids

Dehydroepiandrosterone sulfate (DS), 16α-hydroxydehydroepiandrosterone sulfate (16α-OH-DS) and 16α-hydroxydehydroepiandrosterone (16α-OH-D) were measured in mixed cord plasma and maternal plasma of 6 pregnant women who were treated with prednisone and hydrocortisone succinate during pregnancy and labor. All three steroid hormones were markedly lowered in the fetal blood. (DS: M = 53 μ%, 16α-OH-DS: M = 45 μg%, 16α-OH-D = < 6 μg%). The level of these steroids appears to vary inversely with the amount of corticoids given to the mother. In the maternal blood DS was either not measurable or very low (range < 8–29 μg%) as compared with normal values for untreated pregnant women. No 16α-OH-D or 16α-OH-DS could be detected in the p lasma of these patients. Maternal urinary estriol, estrone, and estradiol were also decreased in three of the cases studied. It is hypothesized that the decrease of urinary estrogens in these patients is mainly due to a suppression of the release of C19-steroid hormones by the maternal and fetal adrenal; the suppression of the fetal adrenal by exogenous corticoids being of major importance. It is pointed out that in cases with corticoid treatment during pregnency a low urinary estrogen excretion does not need to interfere with the development of pregnancy and does not reflect a hazard to the fetus.

Serum FSH and LH measurements in the evaluation of menstrual disorders

Abstract Serum FSH and LH levles were measured serially, for 30 days, in primary, oligo-, secondary amenorrheas, and amenorrheas associated with galactorrhea or obesity. Comparison with normal subjects revealed a lack of the characteristic midcycle FSH and LH hypersecretion in amenorrheic patients. Comparison among the amenorrheic patients, most of whom exhibited normal levels of FSH and LH, revealed differences in absolute levels and ratios of FSH and LH. Striking differences in the day-to-day patterns of serum FSH and LH were also noted. A significant correlation existed between the nature of these gonadotropin patterns and responsiveness of gonadotropins to clomiphene citrate. Thus, amenorrheic patients with either low or normal but unfluctuating gonadotropin levels responded poorly to clomiphene citrate, while those with normal levels which did fluctuate from day to day exhibited an ovulatory-type of gonadotropic response to clomiphene citrate. A hypothesis relating serum gonadotropin patterns to the intensity of hypothalamic regulation of gonadotropins is presented.

Renal Function in Human Pregnancy. I. Changes in Glomerular Filtration Rate and Renal Plasma Flow

Summary 1. Renal function studies were performed on 9 patients during 1st, 2nd and 3rd trimester of pregnancy and in the postpartum period. 2. A progressive increase in renal plasma flow and glomerular filtration occurred, reaching maximum in 3rd trimester and returning to non-pregnant levels after delivery. 3. These changes speak against an added burden imposed on the kidneys by pregnancy.

The ultrastructure of a feminizing granulosa-theca tumor

A 13-year-old girl with evidence of hyperestrinism had a right ovarian tumor removed. This neoplasm was composed predominantly of granulosa cells and exhibited some changes of luteinization. The neoplastic cells displayed an investment of basement membrane material which was closely related to fibrillar collagen within the tumor. Scattered throughout the neoplasms were small numbers of cells with charcteristics of the theca and a few cells had cytoplasmic features suggestive of smooth muscle. The ultrastructural findings of eight similar tumors have been described. In none is the basement membrane material fully appreciated; nevertheless, the production of this extracellular material is a major and distinctive feature of granulosa-theca tumors.

Fetal survival with premature delivery in complications of pregnancy

Abstract The fetal outcome was noted for the last 10,000 deliveries occurring at UCLA. Patients with premature ruptures of the membranes, toxemia, renal disease. RH sensitization, premature separation of the placenta, diabetes, and hypertension were compared to the remainder of the obstetric patients delivered during the same period of time. Our present management is preventing any actual rise in fetal loss due to fetal death in utero in successive stages of pregnancy. However, fetal death in utero does remain a continuing important factor throughout the stages of pregnancy, and if it could be prevented by a test of fetal welfare, infant survival might approach that expected for patients at the corresponding stages of pregnancy with no complications.