Chronic polyhydramnios is a syndrome with a lactogen receptor defect in the chorion laeve

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Abstract
Human chorion laeve contains a lactogenic hormone [prolactin (PRL), growth hormone (GH) and placental lactogen (hPL)] receptor. Binding of the potent lactogen, human GH, to this receptor was studied in 18 normal pregnant women, in 12 patients whose pregnancies were complicated by chronic polyhydramnios and in 13 with chronic oligohydramnios. Polyhydramnios was classified clinically as idiopathic in 7 patients, and secondary and associated with various disorders in the remaining 5 patients. Lactogenic hormone binding was lower in association with polyhydramnios (mean 1.60, SEM [standard error of the mean] 0.15%) than with normal amniotic fluid volume (mean 3.05, SEM 0.40%; P < 0.05); Scatchard analysis indicated that a reduced number of lactogen receptors within the chorion laeve was the reason. The lactogenic hormone receptor defect in the chorion laeve was present in pregnancies complicated by either idiopathic or secondary polyhydramnios. In contrast to chronic polyhydramnios, tissue from patients with chronic oligohydramnios bound lactogenic ligands in a normal fashion. Insulin binding sites were also identified in the chorion laeve, and, in contrast to the lactogens, binding parameters were equivalent in the 3 patient groups. PRL resistance developing subsequent to this chorion laeve receptor defect might produce the excessive amniotic fluid volume characteristic of polyhydramnios. It is proposed that a chorionic PRL receptor deficiency underlies the various clinical forms of chronic polyhydramnios.

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