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Horm Metab Res 1977; 9(5): 409-414
DOI: 10.1055/s-0028-1093492
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© Georg Thieme Verlag KG Stuttgart · New York

Injections of ACTH and HCG into the Fetus during Midpregnancy Legal Abortion Performed by Intraamniotic Instillation of Prostaglandin. Influence on Maternal Plasma Oestrogens and Testosterone

J. R. Strecker , Ch.  Lauritzen , H.  Dahlén , W.  Jonatha , W.  Gossler , U.  Tettenborn
  • Universitäts-Frauenklinik, Ulm, Germany
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Publication Date:
23 December 2008 (online)

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Abstract

In 12 cases of legal abortion between the 12th and 20th week of pregnancy either 80 IU ACTH OL 5000 IU HCG were injected directly into the fetus under ultrasonic visual control in order to study the role of these hormones for the regulation of oestrogen production in midpregnancy. Thereafter, abortion was induced by intraamniotic instillation of 10 mg prostaglandin E2 (PG E2). Increase of oestrogen precursors was achieved indirectly via a possible stimulation of the fetal adrenal cortex by ACTH or HCG. Concentrations of unconjugated oestrone (Oe1), oestradio 1-17β (Oe2), oestriol (Oe3) and testosterone (T) were determined in maternal plasma collected over a 5 hour period before and after injection. As a control group 4 patients received PG E2 only. The following results were obtained:

1. Maternal oestrone, oestradiol-17β and testosterone levels were increased by injection of ACTH and HCG into the fetus.
2. Intraamniotic instillation of prostaglandin together with intrafetal injection of ACTH or HCG reduced the increase of maternal oestrone, oestradiol and testosterone. Oestriol even decreased.
3. The exclusive injection of prostaglandin into the amniotic cavity (control group) was followed by a decrease of ali oestrogen fractions and testosterone.
4. Oestriol levels in maternal plasma correlated well with the deterioration of the fetal condition and fetal death following the induction of abortion.

The findings are interpreted to show the stimulating effect of HCG and ACTH on the fetal adrenal production of DHA-S and to demonstrate the important precursor role of fetal DHA-S for placental oestrogen production and oestrogen levels in the maternal organism. On this basis a theory of the regulation of precursor availability for the placental oestrogen biosynthesis including the corticotropic effects of HCG and ACTH is proposed.

Key words

Fetal Adrenal Steroids - Oestrogens and Testosterone in Pregnancy - ACTH and HCG in Pregnancy