Adrenal Cortical Capacity and Cortisol Utilization in Normal and Toxemic Pregnancies.

Abstract
Forty milligrams of ACTH were given intravenously over 6 or 10 hours to normal and toxemic pregnant patients; plasma 17-hydroxycorticosteroids (OHCS) were determined every 2 hours. Values for 12 normal pregnancies showed a nearly linear rise (possibly not maximal at 10 hours); values for 13 toxemic pregnancies showed less marked increases with maxima in 6 hours or less. The reserve capacity in normal pregnancies is similar to that in non-pregnant subjects. The reduced reserve capacity in toxemic pregnancies may indicate a shift in the normal ratio of production of gluco- and mineralocorticoids. Seventy-five mg cortisol were given intravenously over 0.5 hour to 8 normal and 6 toxemic pregnant patients. Blood was drawn at zero, 1, 2, 4, 6, and 8 hours, and plasma 17-OHCS determined. Utilization of cortisol did not appear to be faulty in either type of patient, both showing ability to remove rapidly an amount of cortisol greatly in excess of the increment seen in pregnancy.