Fetal and maternal erythropoietin levels in normal pregnancy.

In a cross-sectional study of 120 pregnancies undergoing cordocentesis for prenatal diagnosis (n = 90) or elective caesarean section (n = 30), the umbilical cord and maternal venous plasma erythropoietin (Epo) concentrations were measured. Fetal Epo levels increased from a mean of 4 mU/ml at 16 weeks to 13 mU/ml at 40 weeks' gestation. There were no significant associations between fetal plasma Epo concentration and fetal blood gases, haemoglobin concentration, oxygen content or erythroblast count. The maternal plasma Epo concentration (mean = 14 mU/ml, range 1-77 mU/ml) did not change with gestation but was significantly higher than levels in non-pregnant females (mean = 6.6 mU/ml, range 1-25 mU/ml).     

Serum oestriol in normal pregnancy.

Serial measurements of serum oestriol (E3) were made in 56 normal pregnancies from 10 to 40 weeks gestation using a radioreceptor assay. Several parameters of the assay and its intrapatient variability were examined. The mean curve for pregnancy E3 levels and limits of normal variation have been identified and compared with those of other series. A positive correlation was found to exist between infant birth weight and the last E3 value in normal pregnancies prior to the onset of labour. Advantages of serum E3 assays over urinary E3 determinations are discussed.     

Serum estradiol as an aid in the diagnosis of ectopic pregnancy.

The value of serum beta-hCG measurement in the diagnosis of ectopic pregnancy is well established, and there have been recent studies on the use of serum progesterone levels. However, we have been unable to find any reports on the potential application of serum estradiol (E2) assays in the diagnosis of ectopic pregnancy. We therefore concurrently measured serum E2, progesterone, and beta-hCG in 100 women with ectopic pregnancies, as well as in 69 controls with normal intrauterine pregnancies and 36 women with threatened abortion. The mean (+/- standard deviation) E2 levels for ectopic-pregnancy patients, the normal controls, and the women with threatened abortion were 281.1 +/- 115.6, 788.2 +/- 45.5, and 788.8 +/- 40.6 pg/mL, respectively; the mean levels in the ectopic group were significantly different (P less than .0001) from those of the other two groups. All but one of the ectopic pregnancies had values below 650 pg/mL for E2 and 23 ng/mL for progesterone, and all but one of the normal intrauterine pregnancies had values above these levels. Our data suggest that the addition of the estradiol assay, with or without progesterone, to the early evaluation of patients suspected of having an ectopic pregnancy may be helpful in diagnosis.     

Serum amylase changes during pregnancy.

Study of the behavior of serum amylase activity in 200 preganant women in various stages of pregnancy indicated that: (1) serum amylase rises gradually during pregnancy until the twenty-fifth week and thereafter falls slightly; (2) serum amylase values may be found in normal pregnant women during the second and third trimesters that exceed those in normal men and nonpregnant women; (3) during the second trimester of pregnancy there may be an alteration in the relative distribution of the pancreatic and salivary-type isoamylases with the salivary type tending to dominate. Knowledge of these changes is of importance in the clinical assessment of serum amylase values in pregnant women complaining of abdominal pain and other symptoms suggestive of complicating acute pancreatitis. An explanation for the observed changes is not readily available and further study is required.     

Amniotic fluid erythropoietin correlates with umbilical plasma erythropoietin in normal and abnormal pregnancy

In the human fetus, elevated plasma erythropoietin levels have been found in high-risk pregnancies at delivery. We examined the relationship of amniotic fluid erythropoietin and umbilical plasma erythropoietin at delivery in 17 normal pregnancies, 41 hypertensive pregnancies, and 37 insulin-treated diabetic pregnancies terminated by elective cesarean section without labor. An additional 27 insulin-treated diabetic patients were studied after undergoing variable durations (86-1184 minutes) of labor. Erythropoietin was analyzed using a highly sensitive and specific radioimmunoassay technique. Fetal plasma erythropoietin concentrations were elevated above the control upper range (50.3 mU/mL) in 59% of the hypertensives and in 38% of the diabetics. The amniotic fluid erythropoietin values were significantly lower than the umbilical plasma erythropoietin values in each study group. Although the umbilical plasma erythropoietin values in the abnormal pregnancy groups differed considerably from the corresponding levels in the controls, the ratio of amniotic fluid erythropoietin to umbilical plasma erythropoietin was approximately the same in controls, hypertensives, and diabetics. Furthermore, the plasma and amniotic fluid levels (In transformed) correlated highly significantly in all three individual groups in absence of labor. In the diabetic labor group, this relationship was nonsignificant. We conclude that in the absence of labor, amniotic fluid erythropoietin reflects fetal plasma erythropoietin. We speculate that amniotic fluid erythropoietin may be an antepartum indicator of fetal hypoxemia.     

Serum erythropoietin levels in gynecologic cancer patients during cisplatin combination chemotherapy.

To investigate the participation of erythropoietin (Epo) in anemias induced by cisplatin combined chemotherapy, serum Epo levels were measured by radioimmunoassay on a serial basis in eight patients with gynecologic cancer undergoing this chemotherapy. The data demonstrated that serum Epo levels, the mean level before chemotherapy being 20.1 +/- 6.6 mU/ml, were significantly elevated after the first course of the chemotherapy (52.1 +/- 32.2 mU/ml; P less than 0.05) when anemia was not evident. The serum Epo level continued to increase as the course of chemotherapy advanced, and furthermore, patients with normocytic anemia after a multiple course of this chemotherapy still showed high Epo levels (115.2 +/- 53.5 mU/ml) that were appropriate for given degrees of anemia. It is suggested that cisplatin combined chemotherapy caused the elevated serum Epo levels through an unknown mechanism other than anemia, and that in anemias induced by cisplatin, Epo deficiency is not evident.     

Evaluation of amniotic fluid alpha-fetoprotein using an enzyme-linked immunosorbent assay

A simple, inexpensive enzyme-linked immunosorbent assay using commercially available supplies is described. An examination of amniotic fluid alpha-fetoprotein (AFP) values for 15 to 20 weeks' gestation is presented. The interassay coefficient of variation was 12% (N = 40) at a level of 4.75 micrograms/mL. Repeat freezing, thawing, and storage at 4C for three months had no discernible effect on measured AFP value. Data comparison with a radioimmunoassay (RIA) kit indicates similar reliability for both assays. There were no false-negative values (zero of 20). The false-positive rate for RIA was 4.4% (13 of 295) and for enzyme-linked immunosorbent assay was 5.0% (15 of 295).     

Serum deoxycytidylate deaminase as an index of high-risk pregnancy

Summary. Serum deoxycytidylate deaminase (EC 3.5.4.12, dCMP deaminase) activity was routinely estimated over 7 years in 2460 pregnancies. The results confirm that elevated dCMP deaminase activity (>4.8 units) is associated with the development of pre-eclampsia but not with essential hypertension in pregnancy; a high rising level can precede eclampsia. Elevated enzyme activity was also found in women who developed jaundice in pregnancy and in some with apparently normal pregnancies. An unexpected finding was that these so called'false positive' high levels were associated with all the unexplained intrauterine fetal deaths that occurred later in pregnancy. Although elevated dCMP deaminase levels may be associated with a normal outcome, persisting high levels indicate the need for careful monitoring of fetal well being and, in the presence of any other sign of placental insufficiency, delivery should be expedited.     

Serum follicle stimulating hormone levels in human pregnancy.

We describe a specific radioimmunoassay for follicle stimulating hormone (FSH) and the finding of immunoreactive FSH in human pregnancy sera. A total of 394 serum samples was taken from 204 normal pregnant women at different stages of gestation. The FSH levels remained constant throughout pregnancy and no rise was associated with the late first trimester elevation of human chorionic gonadotrophin (hCG).     

Serum adiponectin levels in normal and hypertensive pregnancy.

OBJECTIVE: The aim of this study was to quantify adiponectin levels in women with normal and hypertensive pregnancies to determine whether there is an independent association, while controlling for body fat and insulin sensitivity. METHODS: A cross-sectional study was conducted in the following categories: 12 normotensive non-pregnant women, 10 normotensive, 12 gestational hypertensive, 13 essential hypertensive, and 12 preeclamptic women. All subjects underwent measurements of body fat by bio-impedance analysis and blood sampling. RESULTS: Percentage of body fat and insulin resistance were greater in all pregnant groups compared with non-pregnant women. Adiponectin concentrations were significantly lower in women with normal pregnancies (18.6 +/- 1.4 microg/mL, p = 0.02) compared with non-pregnant women (24.0 +/- 1.5 microg/mL). However, adiponectin levels were not significantly different among normal pregnancy, gestational hypertension (19.0 +/- 3.1 microg/mL), essential hypertension (24.0 +/- 3.7 microg/mL) and pre-eclampsia (22.4 +/- 2.5 microg/mL) groups. Adiponectin levels were inversely related to percent body fat and insulin resistance. When adiponectin levels were corrected for percent body fat and insulin resistance, no significant differences were seen among the study groups. CONCLUSIONS: Adiponectin levels are decreased in normal pregnancy, however this difference disappears when adiponectin levels are corrected for the pregnancy-related increases in body fat and insulin resistance. Adiponectin levels are not altered significantly in states of hypertension in pregnancy compared with normal pregnancy.     

Serum erythropoietin levels in ovarian cancer patients receiving chemotherapy

OBJECTIVE: To investigate the effects of repeated cis-dichlorodiamine-platinum (CDDP) exposure on serum erythropoietin (Epo) levels. STUDY DESIGN: In seven patients with ovarian cancer, Epo and haemoglobin concentration (c(Hb)) were measured before, 24h and 7 days after administration of the first three courses of chemotherapy. In seven control patients undergoing gynaecological surgery for non-malignant reasons, Epo and c(Hb) were measured before, 24h and 7 days after the operation. RESULTS: Following Epo increased, independent of concomitant anaemia, especially after the third course: 51mU/ml (S.D. 46) versus 122mU/ml (S.D. 83) (P=0.02). In the control patients, Epo was lower although the decrease of c(Hb) was significantly higher. CONCLUSION: Cis-platinum chemotherapy induces an increase in erythropoietin levels independent of anaemia. The underlying mechanism remains to be investigated.     

Serum cathepsin activity in pregnancy

Cathepsin activity of blood serum was determined in nonpregnant women and in different stage of pregnancy. A significant, progressive increase in the cathepsin activity was found in pregnancy.     

Detection of pregnancy specific protein SP-1 by enzyme immunoassay in early pregnancy

Levels of pregnancy specific beta 1-glycoprotein (SP-1) were measured serially in serum by using enzyme immunoassay in 10 women after ovulation detected by LH-surge. Serum SP-1 levels rose at 13 and 20 days after the LH-surge.     

Serum progesterone levels as an aid in the diagnosis of ectopic pregnancy

Progesterone levels in 29 women with ectopic pregnancies and 20 women with early intrauterine pregnancies were evaluated using a new direct radioimmunoassay that offers results within four hours. Patients with normal intrauterine pregnancies had serum progesterone levels greater than 20 ng/mL (mean = 30.9 ng/mL) while all patients with ectopic pregnancies had progesterone levels less than 15 ng/mL (mean = 5.7 ng/mL). The incorporation of the progesterone assay into the workup of a patient with suspected ectopic pregnancy can be a useful clinical adjunct to the conventional methods of evaluation.