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PubMed1992

[Evaluation of antenatal monitoring of unconjugated estriol in the saliva].

A new radioimmunoassay kit for unconjugated salivary estriol (SE 3) determination was used to monitor 497 fetuses in late pregnancy, 217 normal and 280 at high-risk. The SE 3 values of normal pregnancy were also measured in 1378 cases at 20th to 41st gestational week. The normal concentration weekly was established. The results were 1. The false negative and false positive rate of SE3 were 2.0% and 0.6%, respectively; thus the correct rate of SE3 in prenatal prediction of fetal well-being was 97.4%, similar to that of serum E3 (95.6%, P greater than 0.05) and significantly higher than that of overnight 12-hour urine E3/C (84%, P less than 0.05). 2. There were 8 fetal deaths of 11 cases with lower SE3, whereas, only one death due to nuchal cord in the 486 with normal SE3, and no perinatal death. It is highly important to collect saliva and measure the SE3 correctly in order to guarantee accuracy of the results. The advantages of salivary SE3 assaying are reliable and being more scientific and practical than that of serum E3. We suggest that determination of SE3 may replace serum E3 measurement for assessing fetal-placental well-being.

Adult↗

PubMed1992

[Vaginal estriol administration in treatment of postmenopausal urinary incontinence].

In an open, prospective, multicenter, controlled study, 629 female subjects suffering from stress and urgency urinary incontinence were treated with vaginally administered estriol at a dose of 0.01 g daily for 3 weeks, and 0.01 g bi-weekly for a further 3 weeks. All data of 552 patients were available at follow-up after 6 weeks of treatment. The subjective improvement in symptoms of stress urinary incontinence (SUI) was 82% for grade 1, 77% for grade 2, and 69% for grade 3. Voluntary urinary control and symptoms of urgency were improved in more than 80% of patients. Frequency was reduced in almost 50%. Compared with conditions at the outset of the study, after 6 weeks, vaginal lubrication is normal in 77%, and intercourse is no longer painful for 88%. Objective parameters were: no change in existing descent of the anterior vaginal wall, and normal cytoscopic findings in 66% of the patients in whom these were previously pathologic. Vaginal atrophy improved in approximately 40% of cases. A quality of life score revealed improvement in 72%, no change in 20% and worsening in 9% of patients compared with conditions at the start of therapy. During therapy, symptoms worsened in 1%; 2% of patients suffered from the adverse effects, with vaginal itching and burning sensations. Our results confirm the value of topical estrogen application as a cornerstone of efficient treatment of stress and/or urge incontinence in the postmenopausal patient.

Administration, Intravaginal↗

PubMed2004

[Studies for analyzing prohibited ingredients such as estriol in cosmetics].

Estriol (EO) is nominated as the prohibited ingredients in cosmetics in Japanese Pharmaceutical Affairs Act. So the analytical method using HPLC for EO was investigated. After placing 1.0 ml of EO solution at 50 microg/ml and 0.5 g of the lotion into a 10-ml volumetric flask, the methanol was added to make until that volume and this solution was used as the testing solution. Milky lotion was procedured as follows: After placing 1.0 ml of EO solution at 50 microg/ml and 0.5 g of the milky lotion into a 10-ml volumetric flask, the methanol was added to make until that volume. The suspending mixture was moved to a centrifuging tube with a cap. After centrifuging at 3000 rpm for 5 minutes, the supernatant was used as the testing solution. The testing solution of 20 microl was determined by HPLC using the ODS column (CAPCELL PAK C18 column, 4.6 x 250 mm), the mixture of water and acetonitrile (31:9) and the detection wavelength of 285 nm. The working curve from 1.0 to 6.0 microg/ml showed a linear line between the concentrations of EO and the peak area. There was no interference of peak of EO from the lotion and milky lotion.

Acetonitriles↗

PubMed1990

Maternal serum screening for aneuploid pregnancy by alpha-fetoprotein, hCG, and unconjugated estriol.

A number of serum screening protocols are either currently in use or proposed to identify pregnant women under 35 years of age who are at increased risk for a Down syndrome fetus. It has been suggested that these same screening methods be applied to gravidas over 35 years of age to identify those women who should be offered amniocentesis. To evaluate the efficacy of screening for detection of aneuploid pregnancy in this age group, the serum samples of 34 women who underwent amniocentesis and who had confirmed fetal aneuploidy were assayed for alpha-fetoprotein (AFP), hCG, and unconjugated estriol (E3). These concentrations were compared with those of 85 women with known euploid pregnancy who underwent amniocentesis for advanced maternal age. The mean multiple of the median (MoM) for each of the three markers was significantly different from control values in cases of trisomy 21 (AFP median MoM = 0.82; unconjugated E3 median MoM = 0.77; and hCG median MoM = 1.89). These differences were not found when other aneuploidies were considered. Likelihood ratios were calculated for cases and controls and examined for their ability to predict the need for amniocentesis, based on currently recommended risk levels. There was a significant difference between the mean likelihood ratio for cases of trisomy 21 compared with that of controls (mean likelihood ratio = 13.48); there was no significant difference for other aneuploidies (mean likelihood ratio = 1.08). Of the 16 cases of trisomy 21 analyzed, four would not have been diagnosed antenatally if recommendation against amniocentesis had been made based on each woman's individual age-specific risk as modified by her likelihood ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗

PubMed1991

Sensitivity and specificity of screening for Down syndrome with alpha-fetoprotein, hCG, unconjugated estriol, and maternal age.

The sensitivity and specificity of maternal serum screening for Down syndrome with different biochemical markers were evaluated. Detection rates with different combinations of maternal serum alpha-fetoprotein (MSAFP), hCG, and unconjugated estriol (uE3) were established by retrieving and analyzing 54 serum specimens from women with confirmed Down syndrome pregnancies, compared with 657 specimens from women with normal outcomes. With a risk cutoff of 1:270 at the second trimester, the detection rate with MSAFP, hCG, and uE3 was two to three times higher than with MSAFP alone. With all three markers, the detection rate for Down syndrome increased from 50 to 77% as maternal age increased, and was 60% in a representative screened population. If uE3 was omitted, the detection rate decreased from 60 to 48%. One thousand women were screened prospectively, either with MSAFP or with all three markers prospectively, either with MSAFP or with all three markers and 4.1% with MSAFP. With the three markers, the positive predictive value for Down syndrome was 2.2% overall and as high as 5.9% in older women. Therefore, the addition of hCG and uE3 to the maternal serum screen increases the positive predictive value by 50-300%, depending on maternal age. These results confirm the efficacy of screening for Down syndrome using maternal age and three serum markers.

Biomarkers↗

PubMed1991

[Local administration of low-dose estriol and vital Lactobacillus acidophilus in postmenopause].

A randomized double-blind trial with 15 postmenopausal women led to a remarkable result. Local treatment with vaginal tablets just containing 0.03 mg estriol proved to be equivalent to the widely used dosage of 0.5 mg. The test drug Gynoflor E induced significant proliferation of the vaginal epithelium and thus offers the basis for a complete restoration of the vaginal environment. Simultaneously given Lactobacillus acidophilus can be implanted successfully and thus an acid vaginal milieu can be restored.

Administration, Intravaginal↗

PubMed1990

Possibility of anti-estrogen action from estriol specific binding sites in rabbit uterus.

1. This study was designed to investigate the clomiphene or tamoxifen binding to receptor sites for estradiol-17 beta (E2R) and estriol (E3R) in the rabbit uterus. 2. Those so-called anti-estrogenic compounds tended to inhibit E2-E2R and E3-E3R bindings equally. 3. The inhibitor constant of clomiphene for E2R was approximately 3.8 x 10(-8) M at 4 degrees C and that for E3R approximately 1.8 x 10(-8) M at 4 degrees C in a given case, determined by charcoal assay. 4. It is suggested that the anti-estrogenic compounds demonstrate their effects after binding either to E2R or to E3R. 5. There were some tissue differences of the contents between E2R and E3R. For example, the uterus and the cortex contained E2R, and the pituitary E3R more than the other.

Animals↗

PubMed1989

[Clinical effects of estriol administration by the vaginal route in physiologic and surgical menopause].

The therapeutic effect of estriol administered by the vaginal route on certain classes of symptoms relating to the climacteric has been assessed in 34 women. The response was generally very satisfactory both as regards neuropsychoendocrine disturbances and as regards urogenital dystrophic signs, in confirmation of the good absorption of the hormone and of its indifferent distribution in the target organs.

Administration, Intravaginal↗

PubMed1979

Urinary excretion of estrone, estradiol, and estriol in postmenopausal women with primary breast cancer.

The daily excretion of estrone, estradiol, and estriol was determined for 22 normal women and 35 women with primary breast cancer. The excretion of the hormones (measured in microgram/24 hr) in the breast cancer group was elevated and showed a statistical significance of P less than 0.001. The same wide difference between the 2 groups was also noted when excretion was expressed in terms of the body area of the individuals and when women of similar ages were compared.

Aged↗

PubMed1986

[Determination of serum 16 alpha-hydroxydehydroepiandrosterone, 16 alpha-hydroxyestrone and estriol by gas chromatography-mass spectrometry and their perinatal movement].

In order to study the mechanism of estriol (E3) formation in the fetoplacental unit, a method for determining E3 and its precursors, 16 alpha-hydroxydehydroepiandrosterone (16 alpha-OH DHA) and 16 alpha-hydroxyestrone (16 alpha-OH E1) in blood using Gas Chromatography-Mass Spectrometry (GC-MS) was newly developed. Deuterium labelled steroids, 3.4.4.-d3-16 alpha-OH DHA 2.4.17.-d3-E2 and 2.4.-d2-E3 were synthesized and used as the internal standards. After removal of free steroids with ether, the residue was solvolyzed and extracted with ethyl acetate as free form. Steroids were analysed after the formation of T.M.S. and T.F.A. derivative. The values for each steroid in maternal peripheral vein blood (M.V.), umbilical artery blood (U.A.) and vein blood (U.V.) were studied. Conjugated steroid values in M.V. obtained at normal vaginal delivery (13 cases) were as follows: 16 alpha-OH DHA 230.3 +/- 76.3 ng/ml, 16 alpha-OH E1 19.34 +/- 7.00 ng/ml and E3 158.8 +/- 50.2 ng/ml (mean +/- S.D.), respectively. The levels of these three steroids in cord blood were significantly higher than those in maternal blood. These results show that the steroids are actively produced in the fetoplacental unit. A significant increase in all the steroids was associated with labor. None of the values for E3 precursors in umbilical blood correlated with that of conjugated E3 in maternal blood. The significance of 16 alpha-OH DHA and 16 alpha-OH E1 as intermediates of E3 formation in the fetoplacental unit is discussed.

Dehydroepiandrosterone↗

PubMed1987

Serum free estriol inefficient in the detection of intrauterine growth retardation.

The value of a single serum free estriol (E3) measurement in the detection of intrauterine growth retardation (IUGR) was investigated. Among the group of 40 mothers later giving birth to a growth retarded baby, E3 was low, i.g. below the level of two lower standard deviations of the mean values, in 9 cases. In the control group of 50 mothers with appropriately grown newborns, none of the E3 values was low. In a group of 42 mothers with a low E3 level, only 10 gave birth to a growth retarded baby. Hence, the sensitivity of a single E3 measurement to detect IUGR is 38%, the specificity 61% and the predictive value 37%. E3 measurement is neither efficient nor accurate in the detection of IUGR.

Estriol↗

PubMed1987

Serum unconjugated estriol levels during spontaneous labor.

We measured maternal serum unconjugated estriol (SUE3) levels in 244 cases (218 cases with labor and 26 without labor) and investigated the relationships among several obstetrical factors and SUE3 levels. There was no significant difference in the SUE3 level between the group with labor and the group without labor. However, the SUE3 level decreased gradually with prolonged duration of labor in multipara. There were significant positive correlations between the SUE3 levels and birth weights (n = 82, r = 0.375, p less than 0.01) or placental weights (n = 82, r = 0.381, p less than 0.01) in the multipara with labor. The SUE3 levels of fetal distress cases (n = 30, 20.0 +/- 8.6 ng/ml) were significantly (p less than 0.05) lower than those without fetal distress (n = 188, 24.5 +/- 9.7 ng/ml). These data suggest that maternal SUE3 might have been affected with feto-placental function, even after the onset of labor SUE3 levels decrease with prolonged duration of labor.

Cesarean Section↗

PubMed1979

Anencephaly and twins: prenatal ultrasound and estriol.

A rare case of anencephalic twin pregnancy diagnosed prenatally with ultrasonography is reported. It is the only case found in the literature in which maternal 24-hour urinary estriol is documented in an anencephalic twin pregnancy. Ultrasound diagnosis and obstetric problems associated with such cases are discussed briefly.

Anencephaly↗

PubMed1985

Granulocyte-macrophage colony-stimulating activity in the serum of estriol-treated mice.

Granulocyte-macrophage colony-stimulating activity (GM-CSA) in mouse serum was examined after a single intraperitoneal injection with 10 mg estriol (E3). GM-CSA was detectable as early as 6 h after E3 administration and reached a peak by 24 h. Elevation of GM-CSA in the serum was maintained for at least 30 days. Using 0.1-10 mg of E3 there was a dose-dependent increase in serum GM-CSA when tested 24 h after E3 treatment. The majority of GM-CSA was adsorbed onto Concanavalin A-Sepharose 4B and was eluted by 0.2 M methyl-alpha-D-mannopyranoside, suggesting its glycoprotein nature. When E3-treated mouse serum was applied onto Sephacryl S-300 without any pretreatment, GM-CSA was detected as a sharp single peak with an apparent molecular weight of 440,000 daltons. When GM-CSA was treated with neuraminidase, however, and then applied to Sepharose CL-6B under disaggregating conditions (6 M guanidine HCl), the minimum molecular weight of the active component was estimated as 13,000 daltons.

Animals↗

PubMed1985

Improved determination of estriol-16 alpha-glucuronide in pregnancy urine by direct liquid chromatography with fluorescence detection.

In this relatively simple, rapid assay of estriol-16 alpha-glucuronide in pregnancy urine, the urine sample is diluted 20-fold with phosphate buffer (pH 5.2) containing 360 mL of acetonitrile and 2 g of cetyltrimethylammonium bromide per liter, then directly injected into the chromatograph. A sample can be assayed within 14 min. Day-to-day CVs ranged from 2.3% at 45 mg/L to 2.9% at 4.8 mg/L. The limit of sensitivity is 0.4 mg/L. Results by the present method (y) correlated and compared very well with those by a method involving fractionation of estrogen conjugates and gas chromatography (x) for 24 samples of pregnancy urine (y = 1.09x + 0.303; r = 0.947). This assay is inexpensive and suitable for complete automation.

Chromatography, High Pressure Liquid↗

PubMed1985

[Studies on the alteration of the unconjugated estriol level of the maternal vein after the onset of labor].

We measured maternal venous unconjugated estriol (UE3) levels in 244 cases (218 cases with labor and 26 without labor). We investigated the relationships between several obstetrical factors and UE3 levels. There was no significant difference between the group with labor and the group without labor. However, in multipara, the UE3 level fell gradually with prolonged duration of labor. There were significant positive correlations between the UE3 levels and birth weights (n = 82, r = 0.375, p less than 0.001), and placental weights (n = 82, r = 0.381, p less than 0.001) in multipara with labor. There was no significant difference according to sex between the UE3 levels of a mother carrying a male or female fetus. The UE3 levels of fetal distress cases (n = 30, mean +/- S.E. 20.0 +/- 8.6 ng/ml) were significantly (p less than 0.02) lower than those without fetal distress (n = 188, 24.5 +/- 9.7 ng/ml). These data suggest that after the onset of labor, maternal venous UE3 has some relationship to feto-placental function.

Body Weight↗

PubMed1979

Clinical use of plasma total estriol measurements in late pregnancy.

A critical review of the clinical use of measurements of plasma total estriol concentration in late pregnancy was done on the basis of one year's experience with the test at one institution which provides tertiary-level care to high-risk obstetric patients. The overall efficiency of the test in discriminating patients at risk was 59%. It appears to be most useful when a negative result provides some reassurance that the status of the fetus is satisfactory.

Estriol↗

PubMed1977

[Clinical study on metabolic effects of estriol-succinate (author's transl)].

Allowing for the restrictions outlined in "Methods", treatment with estriol-succinate of 10 menopausal women for several weeks had no effect on some lipid and carbohydrate parameters, nor on serum enzymes nor plasma hormone levels. A slight increase in serum alkaline phosphatase, within normal limits, could not be related to a disturbance of liver function, when considering the other parameters.

Adult↗