THE URINARY EXCRETION OF 17-HYDROXYCORTICOSTEROIDS IN HUMAN PREGNANCY

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Abstract
SUMMARY: The urinary excretion of 17-hydroxycorticosteroids (17-OH CS) and of one of their subgroups—the 21-deoxyketols (17-hydroxy-20-oxopregnanes)—has been measured in the course (5th to 10th lunar month) of human pregnancy. In twenty-six cases with a normal course of pregnancy the average excretion of 17-OH CS rose slowly to values 40% above the normal average. An additional sharp increase occurred following parturition, but 1 day later the urinary levels returned to normal. The average excretion of 21-deoxyketols rose more steeply to values 800% above the normal average and returned to normal 2 days after delivery. Following intrauterine death (five cases) the excretion of 17-OH CS and of 21-deoxyketols returned to normal values. No such drastic change was found in three cases of stillbirth and in four cases of toxaemia. The significance of these findings is discussed. It is suggested that in pregnancy (i) the urinary excretion of the main metabolites of cortisol is essentially unchanged, while the excretion of 21-deoxycorticosteroids of unknown origin is greatly increased; (ii) 21-deoxyketols are unlikely to derive from cortisol; (iii) the high plasma levels of cortisol indicate that the compound is metabolized at a reduced rate rather than that the activity of the adrenal cortex is enhanced.