Epidemiological and hormone studies in early human pregnancy - normal and abnormal

Macnaughton, Malcolm Campbell (1970) Epidemiological and hormone studies in early human pregnancy - normal and abnormal. MD thesis, University of Glasgow.

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Chapter 1. Introduction to the Thesis. Chapter 2. Epidemiological studies in abortion, and subsequent reproductive performance. 1. Woman who start childbearing with 1 or 2 consecutive abortions are compared with those who start with 1 or 2 normal pregnancies. 2. Women who start childbearing with 2 abortions are older, shorter and of lower socio-economic status than the other 3 groups. 3. In the first continuing pregnancy these women have a higher incidence of threatened abortion and premature labour. Their perinatal mortality is increased due mainly to 'prematurity' and 'foetal deformity'. They also have an increased incidence of operative delivery. 4. The group with 2 previous abortions have a tendency to poor foetal growth and this is associated with premature labour. 5. Women who abort their first pregnancy have an increased risk of abortion in their subsequent reproductive life. 6. The recurrent abortion risk increases with successive consecutive abortions from 25% after 1 abortion to 58% after 3 abortions. 7. One third of abortions occur before 2 months gestation and 50% by 3 months. 8. In abortion studies the 'primary recurrent aborter' with 2 or more consecutive abortions should be studied. Observations must start before 8 weeks of gestation or earlier if a previous abortion has occurred before this time. Chapter 3. Hormone assays in normal early pregnancy, in abortion and in hydatidiform mole. 1. Urinary pregnanediol and oestriol assays are made in 3 groups of women (1) Normal pregnancy (2) Women with at least 2 previous abortions and no successful pregnancies and 3) Women who aborted in the pregnancy studied. 2. There is no significant difference in oestriol and pregnanediol excretion between the women who Chapter 5. Progesterone metabolism in the human previable foetus. 1. Perfusion of previable foetuses with 4-C14 progesterone for M and 46 min., showed that 40% of the radioactivity is present in the liver at 14 min. mainly as 20a dihydroprogesterone and in the adrenal 3.4% of radioactivity is present, mainly as polar compounds. After 45 min. the main compound in the liver was pregnanediol and in the adrenals, polar compounds probably corticosteroids. 2. The foetal liver is the chief site of progesterone metabolises and this organ produces mainly reduced metabolises. The adrenal metabolises progesterone to corticosteroids. 3. Progesterone from the placenta is used by the foetus to produce corticosteroids for its own homeostasis. Chapter 6. Steroid studies in a case of hydatidiform mole. 1. The urinary pregnanediols paegnanetriol ratio in molar pregnancy is 2s1 compared with 20s1 in normal pregnancy. 2. Mole tissue was incubated with [4-14C] pregnenolone as precursor, and 17alpha hydropregnenolone, progesterone, 16alpha hydroxyprogestrone and 16alpha hydroxyprogesterone were isolated. 3. Cholesterol, pregnanetriol and androstenedione were isolated from extracts of mole tissue and theca lutein cyst fluid: 17alpha hydroxyprogesteorne was isolated from cyst fluid but not from mole tissue. 4. Mole tissue is capable of steroidogenosis but there was less synthesis of progesterone than normal. 5. The increase of 17alpha hydroxylation indicated by the elevation of urinary pregnanetriel excretion is ovarian in origin. Chapter 7. Urinary steroid excretion after gonadotrophin therapy. 1. There is a significant increase in pregnanediol excretion in the luteal phase of the menstrual cycle due to the ovarian production of 17alpha hydroxyprogesterone. 2. Urinary pregnanetriol excretion also rises in the luteal phase of gonadotrophin stimulated cycles and in gonadotrophin induced pregnancies until 6-8 weeks. 3. Measurement of this metabolite may be a valuable parameter of corpus luteum function in the menstrual cycle, and in early pregnancy. This assay may be of value in detecting hyperstimulation of the ovaries by gonadotrophins. It may also indicate when the corpus luteum of pregnancy is deficient and be of help in forecasting early abortion.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: James Walker
Keywords: Epidemiology, Obstetrics
Date of Award: 1970
Depositing User: Enlighten Team
Unique ID: glathesis:1970-73901
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56
URI: http://theses.gla.ac.uk/id/eprint/73901

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