Regulations on registration of a fetus papyraceus need to be revised.
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Biomedical subjects
Publications and source records attributed to R F Heys.
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The cortisol binding capacity of maternal and cord plasma samples obtained at delivery from fifteen women and their normal infants and from seven women and their anencephalic infants was measured at 4 degrees C by a gel filtration technique. The concentration of oestrogen in these samples was measured by radioimmunoassay. There was no significant difference (t test) between the cortisol binding capacity of peripheral plasma from women with normal infants (1-55 +/- 0-24 mumol/1, mean +/- SD) and from those who delivered anencephalic infants (1-35 +/- 0-30 mumol/1), nor between the cortisol binding capacity of cord plasma from anencephalic infants (0-47 +/- 0-04 mumol/1) and that of normal infants (0-37 +/- 0-10 mumol/1). However, mean oestrogen concentrations in maternal and cord plasma from the pregnancies with an anencephalic fetus were significantly lower (P less than 0-01) than in the corresponding samples from normal pregnancy. It is concluded that oestrogen concentrations in maternal and cord plasma in normal pregnancy at delivery are much greater than those required to account for the increase in plasma cortisol binding capacity. Since plasma cortisol binding capacity in pregnancy with an anencephalic fetus is not diminished, the reduced excretion of corticosteroids relative to normal pregnancy in this condition is unlikely to be due to alterations in cortisol metabolism associated with a lower plasma cortisol binding capacity.
During late pregnancy the urinary excretion of steroid 21-deoxyketols, which contain the CH3-CO-C(OH)less than side chain, was 1.16 +/- 0.50 mg/24 h (mean +/- SD n = 9). The mean excretion of these metabolites in 8 pregnancies with an anencephalic foetus showed a significant reduction (P less than 0.01, t-test) to 0.42 +/- 0.18 mg/24 h. Six untreated non-pregnant women and 7 taking oral contraceptives which contain oestrogen had steroid 21-deoxyketol excretions of 0.26 +/- 0.09 mg/24 h and 0.19 +/- 0.09 mg/24 h respectively. These results imply that the adrenal of the normal foetus makes a contribution to the secretion of those steroids which are ultimately excreted by the mother as 21-deoxyketols.
The quantities of nine corticosteroids in 24 h urine samples collected by pregnant women (nine with normal foetuses and nine with anencephalic foetuses) were measured after hydrolysis with beta-glucuronidase and separation by paper chromatography. The excretion (mumol/24 h, mean +/- S.D.) of prenanetriol (0-85 +/- 0-17), 3 alpha, 17 alpha-dihydroxy-5 beta-pregnan-20-one (17 alpha-hydroxypregnanolone, 0-55 +/- 0-17), 3 alpha, 17 alpha, 21-trihydroxy-5 beta-pregnan-20-one (tetrahydro-11-deoxycortisol, 0-17 +/- 0-14) and tetrahydrocorticosterone (0-65 +/- 0-26) by women with an anencephalic foetus was significantly lower (P less than 0-01 or less than 0-05) than the excretion of these compounds by women with a normal foetus (pregnanetriol, 2-42 +/- 0-62; 17 alpha-hydroxypregnanolone, 2-72 +/- 0-69; tetrahydro-11-deoxycortisol, 0-56 +/- 0-37; tetrahydrocorticosterone, 1-95 +/- 0-94). These differences suggest that the adrenal of the normal foetus contributes to the quantity of pregnanetriol, 17alpha-hydroxypregnanolone, tetrahydro-11-deoxycortisol and tetrahydrocorticosterone in maternal urine. The excretion of tetrahydrocortisol, tetrahydrocortisone, tetrahydrodeoxycorticosterone, cortol and cortolone were similar in both groups of subjects. No evidence was obtained therefore to indicate the secretion of cortisol or deoxycorticosterone by the foetal zone of the adrenal of the undisturbed human foetus in late gestation.
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