Oestrone, oestradiol and oestriol glucosiduronates and sulphates in human puerperal plasma and milk

Conjugated and unconjugated oestrone, oestradiol and oestriol were measured in simultaneous milk and plasma samples obtained from 21 women in the early post-partum period. Conjugated oestrogens comprised more than 90% of the total oestrogen content of both milk and plasma. Oestrone glucosiduronate was the major oestrogen metabolite in milk (33%), the levels being significantly higher (P less than 0.01) than in plasma. Oestriol glucosiduronates were the predominant oestrogen metabolites (63%) in plasma.

Homogeneous enzyme immunoassay of estriol in picogram amounts

A homogeneous enzyme immunoassay for estriol has been described using estriol-glucose-6-phosphate dehydrogenase (E3G6PD) as enzyme conjugate. Antisera for estriol were raised by immunising rabbits with two different immunogens, estriol-6-(O-carboxymethyl oxime) bovine serum albumin (E36CMOBSA) and estriol-3-carboxymethyl ether bovine serum albumin (E33CMEBSA). A new method for preparation of estriol 3-O-carboxymethyl ether in high yield (90%) has also been described. Addition of anti-estriol antibodies to E3-G6PD conjugate resulted in inhibition of enzyme activity. In the presence of free estriol, the antibody induced inhibition of enzyme activity was reduced in a concentration dependent manner. The use of the heterologous combination between immunogen and enzyme conjugate, i.e. using anti-E33CMEBSA and E36CMOG6PD improves the sensitivity at the expense of specificity, the cross-reaction with other estrogenic hormone being 10-15%.

[The betamethasone test in the diagnosis of placental insufficiency]

A trial to evaluate a functional test of the fetoplacental unit by measuring the extent of suppression of maternal estriol serum levels by glucocorticoids is described. 21 women between the 30th and 40th week of gestation received 4 mg betamethason intravenous injection at 8.30 a.m. Blood samples were collected immediately before betamethason application and at 1.00 p.m., 4.00 p.m., 8 p.m. o'clock and at 8.30 a.m. on the next day. Estriol (E3), cortisol, dehydroepiandrosterone sulfate (DHEA-S) and human placental lactogen (HPL) were determined from serum samples by radioimmunologic methods. Patients were divided into 3 groups: severe placental insufficiency (group I, n = 6) described by growth retardation of the fetus of more than 2 weeks, normal gestations (group II, n = 8) and slight growth retardation (group III, n = 7). After temporary suppression in groups II and III, E3, DHEA-S and cortisol levels showed a significant increase the day after betamethason. In group I an increase of these parameters was observed 2 to 5 days after betamethason. These results show that a low intravenous dosage of betamethason and collection of blood samples for E3 assays in intervals of 12 hours can be used as a functional test of the fetoplacental unit.

Salivary unconjugated estriol levels in normal third trimester pregnancy - direct correlation with serum levels

A radioimmunoassay for salivary unconjugated estriol concentration during the third trimester of normal pregnancy is described. The performance characteristics of the method were established by determining the non-specific binding, the blank value of the endogenous estriol free ("stripped") saliva, the recovery experiment and intra- and interassay coefficient of the variations. The corresponding serum samples were also analyzed by the same method. An excellent correlation was found between salivary and serum estriol concentrations.

[Progesterone and unconjugated estriol in amniotic fluid and serum in diabetic patients during induction of labor]

Progesterone and unconjugated estriol are radioimmunologically estimated in 42 diabetic patients in amniotic fluid and serum during last weeks of pregnancy and in the course of oxytocin-induced parturition. As unconjugated estriol rises in progressing weeks of pregnancy progesterone remains unchanged in both investigated fluids. The quotient progesterone unconjugated estriol correlates with affection to labour. There is no statistically significant change in both steroid hormones during induced labour.

Radioimmunoassay for salivary estriol, with use of an 125I radioligand and a solid-phase separation technique

This simple, rapid radioimmunoassay for salivary unconjugated estriol in the third trimester of pregnancy is based on use of a Sepharose-coupled antiserum and a radioiodinated tracer, and requires only a 15-min incubation. Estriol conjugates are shown not to be present in saliva in significant concentrations; therefore a preliminary extraction is unnecessary. Determinations of unconjugated estriol in matched specimens of plasma and saliva correlate well (r = 0.95). A provisional normal range for 30 weeks to term agrees closely with those reported by others. This assay can give results quickly for the large numbers of specimens generated by weekly or daily sampling regimes.

Studies on steroids. CLXXIX. Determination of estriol 16- and 17-glucuronide in biological fluids by high-performance liquid chromatography with electrochemical detection

A high-performance liquid chromatographic method for the determination of estriol 16-glucuronide and 17-glucuronide in bile and urine has been developed. The electrochemical detector was found to be more superior than the UV detector with respect to selectivity and sensitivity and therefore more suitable for the determination of estrogen conjugates in biological fluids. The use of the present method revealed that both estriol 16-glucuronide and 17-glucuronide were excreted in rat bile, while only the former was present in human pregnancy urine.

The use of antenatal tests of fetal welfare

The value of antenatal tests of fetal welfare is a constant source of controversy and confusion to obstetricians and general practitioners. The proliferation of such tests indicates that none is ideal and all are relatively imprecise.

[Endogenous prostaglandins and steroid hormones in premature labor induction in diabetic patients]

Prostaglandins E and F2 alpha as well as two steroid hormones, progesterone and unconjugated oestriol, were measured in amniotic fluid of 30 diabetics. The prostaglandin levels of all patients went up with significance after the os uteri had clearly opened. No rise in prostaglandin levels was recordable from induction of labour without opening of the os uteri. High primary prostaglandin levels, prior to induction of labour, and low progesterone/oestriol quotients were observed along with short-time courses of parturition. On the other hand, low prostaglandin values prior to induction of labour and slow rise during induction were recordable from protracted courses of labour.

The changing estrogen content of the nuclear fraction of human myometrium during labor

The cytosol and nuclear fractions were prepared from 32 pieces of myometrium obtained from 20 elective cesarean sections (regarded as typical of quiescent pregnancy (P)) and 12 emergency cesareans (performed after labor had started and therefore taken as typical of labor (L)). The nuclear fraction was purified by standard procedures. All protein-bound estrogen was released from the nuclear fractions, and the released estrogen simultaneously solubilized by denaturation with ethanol. The estriol (E3) and estradiol (E2) content of the alcohol solutions were assayed by radioimmunoassay with highly specific antisera for E3 and E2. In the L group, average E3 content was slightly (not significantly) lower, and average E2 content was significantly (P less than 0.005) higher, than in the P group. The E3/E2 ratio decreased dramatically (P less than 0.001) during this change from P to L.

[The determination of unconjugated estrone, estradiol, estriol and estetrol in serum or amniotic fluid by high performance liquid chromatography with an amperometric detector (author's transl)]

A simultaneous microdetermination of unconjugated estrone, estradiol, estriol and estetrol in serum or amniotic fluid by High Performance Liquid Chromatography with an Amperometric Detector is described. Steroids in serum or amniotic fluid were extracted with 10 volumes of ethyl ether, and then ether extract was evaporated to dryness under N2 gas. After defatting with a mixture of 50% methanol/n-hexane, the methanol phase was evaporated to dryness under N2 gas. The residue was applied to microcolumn packed with 2 ml volume of Sephadex LH-20 in the eluting solvent benzene/methanol (85:15). Fractions contained estrone and estradiol; estriol and estetrol were collected and then evaporated to dryness under N2 gas. The sample solution was applied to HPLC using a reverse phase ODS column and acetonitrile: 0.1M KH2 PO4 47:53 for estrone and estradiol fraction, and 30:70 for estriol and estetrol fraction as a mobile phase, respectively. The fraction of each estrogen was separated completely within a 20 minute period. The limit of detection of estrone, estradiol, estriol and estetrol was 50 pg, respectively.

Oxytocin challenge test and intrauterine growth retardation

On the basis of analyses of the nonstressed fetal heart rate test (NST) and the oxytocin challenge test (OCT) in 85 fetuses with intrauterine growth retardation (IUGR), the predictive power of NST/OCT on fetal outcome and the mechanism of a positive OCT in IUGR were investigated. These fetuses with IUGR exhibited high incidences of nonreactive NSTs (35.3%) and positive OCTs (40%) attributable to a combination of compromised placental function and diminished fetal reserve. Adverse fetal prognosis is most accurately predicted by the joint occurrence of a nonreactive NST and a positive OCT (92%). In such cases, when IUGR is strongly suspected, liberal use of cesarean section is recommended to assure good fetal outcome.

Relation of estriol in saliva to serum estriol during normal pregnancy

As saliva is an easily accessible biological material, compared with 24-hour urine and blood, the salivary concentration of estriol was studied from the 30th to the 41st week of gestation in 268 samples from 124 normal pregnancies. At the same time, venous blood samples were drawn and analyzed for total and unconjugated estriol. The mean values for the concentration of total estriol in saliva in the 30th and 41st weeks were 2.8 and 7.2 nmol/l respectively. The salivary estriol concentration appears to increase in perfect conformity with its serum concentration in the course of gestation. If estriol in saliva also reflects low serum values and an impaired function of the feto-placental unit, analyses of the saliva may be applicable as a screening procedure in high-risk pregnancies.

Biosynthesis of 16 alpha, 17 alpha-epoxy-oestratrienol in rat liver microsomes

After incubation of 1,3,5(10),16-oestratetraenol, a 16-dehydrosteroid, with rat liver microsomes, 16 alpha, 17 alpha-epoxy-oestratrienol was isolated as metabolite. The compound was detected by the use of mass fragmentography after purification of the incubation extract by thin-layer chromatography. Since the epoxide is rapidly hydrolysed by a hepatic epoxide hydratase, only very small concentrations of this metabolite were present in the incubation extract. When styrene oxide was added to the incubation mixture as inhibitor of the epoxide hydratase, the yield of the steroid epoxide increased considerably. Final identification of the oestrogen epoxide was performed by recording mass spectra and by comparison with authentic reference material.

Placental proteins and steroid hormones in the soluble fraction of human syncytiotrophoblast plasma membrane

Placental protein 5 (PP5), pregnancy-specific glycoprotein (SP1), pregnancy-associated alpha 2-glycoprotein (SP3) and chorionic gonadotrophin could not be demonstrated in appreciable molar quantities in the soluble fraction from microvillous plasma membrane preparations isolated from the syncytiotrophoblast of full-term human placentae. However, progesterone, total oestriol and placental lactogen may have some association with this membrane.