Excretion of Estrogen and Gonadotropin in Late Pregnancy

Summary The excretion of estrogen and gonadotropin has been determined in 74 cases during pregnancy; 70 cases were studied during late pregnancy (thirty-five weeks) and 4 cases in early pregnancy. Of the 70 cases studied in late pregnancy, 57 cases were used for a statistical study of the relation of these hormones to the toxemias of pregnancy. Of these, 43 cases (11 normal, 14 hypertensive and renal disease, 13 pre-eclamptic, and 5 eclamptic patients) had parallel quantitative assays of both estrogens and gonadotropins and 14 estrogen only. The other 13 cases represented various other conditions complicating pregnancy. In the group (43 cases) in which both the estrogens and gonadotropins were determined, there was a decrease in the estrogen excretion and an increase in the excretion of gonadotropin in the pre-eclamptic and eclamptic groups, but the excretion of estrogen was normal and the excretion of gonadotropin increased in the hypertensive and renal disease group. Because of the extreme variability of individual values the relationship of the estrogen and gonadotropin excretions (E :G ratio) is believed to be a better index of hormone values than the twenty-four-hour excretion value for either hormone. The values found for this group were 1. The excretion of estrogen (Mean ± S. E., LU, per 24 hours) for the various groups was: normal, 38,260 ± 5,240; hypertensive and renal disease, 37,540 ± 5,770; pre-eclamptic, 17,620 ± 3,030; eclamptic, 11,800 ± 3,670. 2. The excretion of gonadotropin (Mean ± S. E., R.U. per 24 hours) for the same groups was: normal, 12,340 ± 2,760; hypertensive and renal disease, 20,690 ± 2,660; pre-eclamptic, 24,470 ± 3,960; eclamptic, 76,860 ± 31,210. 3. The ratios of the excretion of estrogen to gonadotropin expressed as the Mean ± S. E., for the above groups were: normal, 6.38 ± 2.13; hypertensive and renal disease, 2.63 ± 0.77; pre-eclamptic, 0.97 ± 0.23; eclamptic, 0.28 ± 0.08. Comparisons of these means by the Fisher method gave the following probabilities, P,* for significant differences between the various groups: 1. For the excretion of estrogen per twenty-four hours, these values for the different groups were: normal and pre-eclamptic, P = 0.9; pre-eclamptic and hypertensive and renal disease, P = 2. For the excretion of gonadotropin per twenty-four hours in the same groups, the values were: normal and pre-eclamptic, P = 0.03; normal and hypertensive and renal disease, P = 0.04; pre-eclamptic and hypertensive and renal disease, P = 0.43. 3. For the estrogen:gonadotropin ratios the values were: normal and pre-eclamptic, P = 0.01, including the eclamptic group, P = The total group of estrogen studies (43 cases above and 14 with estrogen determinations only) gave the following values (Mean ± S. E., I.U. per 24 hours) for the various groups: normal, 36,550 ± 4,780; hypertensive and renal disease, 35,580 ± 4,490; pre-eclamptic, 18,490 ± 2,600. Comparison of these means shows a significant difference between the normal and the pre-eclamptic groups (P = Methods for the quantitative assay of estrogens and gona'dotropins employing dose-effect standardization curves and methods of extraction are described and discussed. Excretion of estrogen and gonadotropin has been studied in 17 additional cases representing the following conditions: early pregnancy, hyperemesis gravidarum, abruptio placentae, hysteria with polyhydramnios and partial separation of the placenta, epilepsy, death of fetus, diabetes insipidus, diabetes mellitus, edema, achondroplastic dwarfism, and pseudomucinous cystadenoma of the ovary.