VERMINDERTE OESTROGEN-AUSSCHEIDUNG IN DER SCHWANGERSCHAFT NACH SUBTOTALER ADRENALEKTOMIE

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Abstract
The uneventful course of pregnancy in a patient who had undergone subtotal adrenalectomy for Cushing''s Syndrome 16 months prior to the onset of pregnancy is reported. The urinary steroid excretion was followed throughout pregnancy; during the last 3 weeks before delivery daily determinations were carried out. The 17-keto-steroid output was somewhat elevated in this period as compared with non-pregnant values, while no change in the excretion of 17-hydroxy-steroids was observed; the pregnanediol values were within the low normal range for the relevant periods of pregnancy. The most striking feature was a significantly low excretion of estriol, estrone and estra-diol-17[beta] throughout the last 2 weeks ante partum, the output of the total estrogens did not exceed 5 mg/day. The results are discussed with regard to the role of the maternal and fetal adrenals in placental steroidogenesis.