Steroids, Amniotic fluid

Steroids have been measured by GC-MS in umbilical cord blood, amniotic fluid, and infancy urine of affected infants, and almost no steroids are found [73]. Only traces of progesterone metabolites were detected. Serum samples from women carrying an LAH fetus have normal concentrations of progesterone metabolites, formed pla-centally, since this organ produces the hormone independently of the StAR protein mechanism. 

AMNIOTIC FLUID. Determination of estriol in amniotic fluid using the preceding procedure is somewhat different due to the fact that amniotic fluid contains protein, and it is more difficult to remove the steroids because of protein binding. 

Organic acids have also been studied in plasma, e.g. [341], amniotic fluid [363] and CSF [364]. Several other classes of compounds have received attention in profile analysis, most notably steroids (see above under Steroids) and amino acids [340,341]. 

Wu CH, Mennuti MT, Mikhail G. Free and protein-bound steroids in amniotic fluid of midpregnancy. Am J Obstet Gynecol 1979 133 666-72. 

In the first place the discovery of the secretion of DHA-sulfate by the adrenal cortex in apparently major quantities suggested a hitherto completely unsuspected role of steroid sulfates in steroid biosynthesis and metabolism. Second, a number of steroid metabolites conjugated with two molecules of glucuronic or sulfuric acid were discovered, particularly in pregnancy urine, amniotic fluid, and in perfused placentofetal preparations. Finally, isotopic studies revealed several cases in which administered doubly labeled steroid conjugates were metabolized in the steroid part of the molecule without hydrolysis of the conjugate (e.g., D4, R5 cf. B5). 

Thus, in infants, it is in the presence of a complex and changing normal pattern that any abnormality of steroid metabolism must be identified. Three media are available in reasonable quantity for investigation (1) a sample of amniotic fluid may be collected at birth, and since this contains steroids excreted in urine by the fetus, its contents may give an... 

The metabolism of the C19 and C21 steroids and estrogens in the fetus will be considered separately, and a separate subsection on the steroid content of amniotic fluid has been included. 

Steroid Content op Normal Amniotic Fluid in Late Pregnancy... 

Fig. 6. The content of the major 3j8-hydroxy-A steroids in adult male urine, infant urine, term amniotic fluid, and plasma obtained from the umbilical cord at birth.

The 3j8-hydroxy-A steroid content of amniotic fluid (S12) is compared with that in adult and infant urine and umbilical cord blood in Fig. 6. Schindler and co-workers have assayed several 3/3-hydroxy-A steroids and others in amniotic fluid for both normal and abnormal pregnancies (S4, S5). 

Knowledge of steroid metabolism during early life is far from complete, and it is highly probable that some of the steroids present have a definite role in infant survival, and are not produced solely by the vestigial remains of a system of metabolism designed for uterine life. It is likely that further research will indicate new clinical applications for the investigation of already identified steroids, unidentified compounds, or the profiles of both, in amniotic fluid, umbilical cord blood, and infant urine. 

Schindler, A. E., and Siiteri, P. K., Isolation and quantitation of steroids from normal human amniotic fluid. J. Clin. Endocrinol. Metdb. 28, 1189-1198 (1968). 

Shackleton, C. H. L., and Mitchell, F. L., The measurement of 3/3-hydroxy-A steroids in human fetal blood, amniotic fluid, infant urine and adult urine. Steroids 10, 359-385 (1967). [Note publisher s errors, corrections given in Steroids 11, 415... 

In 1971, Makino et al. found that considerable amounts of 3jS-hydroxychol-5-en-24-oic acid were excreted in urine of children with extrahepatic biliary atresia [111]. Since then, the unsaturated C24 bile acid has been identified in human meconium [112,113], amniotic fluid [114,115], gallbladder bile from premature and term infants [116], urine from children and adults, both healthy and with liver disease [82,117], and bile and feces from newborn and fetal guinea pigs [118]. The natural occurrence of 3j8-hydroxychol-5-en-24-oic acid suggests that the side chain of cholesterol is degraded before modification of the steroid ring system (Chapter 9). 

A Method for Estriol Estimation in Amniotic Fluid and Its Use in the Study of Normal and Abnormal Pregnancy 73. Steroids 13(5) 651-670 (1969) CA 71 ... 

Profile of Steroids in Amniotic Fluid of Normal and Complicated Pregnancies... 

Gas Chromatographic and Mass Spectrometric Identification of Neutral and Phenolic Steroids in Amniotic Fluid... 

Profiling Amniotic Fluid Steroids by Isotope-Dilution Gas Chromatography-Mass Spectrometry... 

Table II lists the principal steroid conjugates isolated in various fetal tissues, amniotic fluid, and cord blood.

Significant ejuantities of estriol, estriol sulfate, and estriol glucuronidc are localized in the amniotic fluid (TToen et aL, 1961), and since this compartment exhibits a high sulfatase activity, it can be concluded that fetal membranes and the amniotic cavity are actively involved in the interchange of steroid conjugates between fetus and mother. 

Table III lists the concentrations of different free and conjugated steroids in cord blood, placenta, and amniotic fluid compared to peripheral maternal...

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