Premium
THE EFFECTS OF ADRENOCORTICOSTEROID THERAPY ON URINARY OESTRIOL EXCRETION IN PREGNANCY
Author(s) -
Khoo S. K.,
Mackay E. V.
Publication year - 1969
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1969.tb103397.x
Subject(s) - excretion , medicine , pregnancy , betamethasone , urinary system , prospective cohort study , physiology , fetal distress , endocrinology , obstetrics , fetus , biology , genetics
A detailed prospective study of the pattern of urinary œstriol excretion in six pregnant women who were given adrenocorticosteroids is presented. An attempt is made to examine the relationship between œstriol excretion and the dose of equivalent adrenocorticosteroid, and to study the effects on the fœtus. A urinary œstriol excretion rate of less than the lower limit of normal was obtained in five of the six cases. Very low levels of œstriol excretion were present in two cases in which the patients were treated with large doses of triamcinolone and betamethasone, and despite this, the babies survived. There was only one fœtal death, occurring in the case of a woman with disseminated lupus erythematosus; otherwise, the fœtal prognosis appeared to be good, no evidence of fœtal distress in labour was encountered, and the placentas were unremarkable. The reduction in œstriol excretion during adrenocorticosteroid therapy is discussed with reference to the literature. Current knowledge of œstriol biosynthesis in pregnancy is briefly reviewed, and the possible mechanism of œstriol depression is suggested. The interpretation of œstriol levels under such circumstances should be made with caution; the levels may not indicate fœtal compromise, even when markedly reduced.