UNCONJUGATED OESTETROL IN PLASMA IN RESPONSE TO AN INTRAVENOUS LOAD OF DEHYDROEPIANDROSTERONE SULPHATE (DHAS) IN UNCOMPLICATED AND COMPLICATED HUMAN PREGNANCY

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Abstract
A non-chromatographic radioimmunoassay for estimation of unconjugated estetrol in plasma from pregnant women is described. The antiserum has a high specificity to estetrol and the technical procedure is simple and rapid. Only small amounts of plasma (0.2-0.4 ml) are needed for analysis. The method was applied to the measurement of estetrol in plasma from pregnant women before and after an i.v. injection of 50 mg DHAS. In women with uncomplicated pregnancies a rise of plasma estetrol was found 60 min post-injection. From 120-360 min, there was a plateau level; at 600 min a decrease from this level was observed. No changes in the estetrol response were found with advancing gestational age from wk 33-40 of pregnancy. A great spread in the individual responses were recorded. Patients with pre-eclampsia and intrauterine growth retardation had a tendency to a lower increase and patients with diabetes a tendency to a higher increase of plasma estetrol after the DHAS administration. The increase of plasma estetrol after an i.v. injection of DHAS in most cases is secondary to the increase of plasma estradiol. Measurement of unconjugated estetrol in plasma after an i.v. load of DHAS is not a safe way to assess fetal well-being. In women with intrauterine growth retardation (IUGR) the simultaneous measurement of plasma estradiol and estetrol after an injection of DHAS may distinguish placental causes of this syndrome from fetal causes.

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