Discordant secretion of pregnancy specific beta 1-glycoprotein and human chorionic gonadotropin by human pre-embryos cultured in vitro.

OBJECTIVE: To study and compare the secretion of pregnancy specific beta 1-glycoprotein (SP1) and human chorionic gonadotropin (hCG) by human pre-embryos, cultured in vitro, with their respective morphological development. DESIGN: Spare human pre-embryos from randomly selected women participating in a program of in vitro fertilization (IVF) were studied prospectively. SETTING: Pre-embryos were cultured, and hormone release was determined in academic research laboratories. PATIENTS, PARTICIPANTS: Pre-embryos (n = 108) cultured for 14 days after fertilization in Ham's F-10 medium (GIBCO Ltd., Paisley, Scotland) were observed, and hCG and SP1 were measured in the culture media at regular intervals. MAIN OUTCOME MEASURES: Discordant secretion of SP1 and hCG. RESULTS: Of the 98 bipronucleate pre-embryos, 53.6% formed blastocysts, 17.3% of which hatched. Human chorionic gonadotropin was detected from day 7 after fertilization concomitantly with blastocyst formation, thereafter showing a logarithmic increase (maximum 10,650 mIU) until the first signs of embryonic disintegration. Pregnancy-specific beta 1-glycoprotein release started 3 to 4 days after fertilization independently of the morphological development and the future production of hCG, thereafter displaying a nonlogarithmic increase (maximum 41 ng). CONCLUSIONS: Hormone secretion and morphological development are unique for each pre-embryo. Human chorionic gonadotropin and SP1 seem to have different biochemical and physiological regulation.

Pleural fluid and serum soluble interleukin-2 receptors in pleural effusions.

Pleural fluid and serum soluble Interleukin-2 receptors (sIL-2R) were measured by an enzyme-immunoassay in 13 patients with tuberculous pleurisy, in 28 patients with carcinomatous pleurisy and in 17 transudates from patients with congestive heart failure. Significantly higher values of sIL-2R were observed in exudative than in transudative (mean +/- SEM = 713 +/- 111 U/ml) pleural fluid samples, the highest being found in tuberculous (3777 +/- 501 U/ml) and the intermediate in carcinomatous exudates (1981 +/- 160 U/ml) (p less than 0.0001; on way ANOVA). Serum sIL-2R were significantly higher in carcinomatous and transudative groups than in age- and sex- matched controls (p less than 0.002; one way ANOVA), while there was no significant difference between the tuberculous group and controls. The pleural/serum sIL-2R ratio was significantly higher in tuberculous (5.32 +/- 0.60), than in carcinomatous pleurisy (2.67 +/- 0.20) and higher still than in transudates (0.76 +/- 0.10) (p less than 0.001; one way ANOVA). In conclusion, the pleura/serum sIL-2R ratio may be a helpful parameter in differentiating tuberculous from carcinomatous pleurisy and an additional confirmatory one for distinguishing transudates from exudates.

Soluble interleukin-2 receptors (sIL-2R) and neuron specific enolase (NSE) in small cell lung carcinoma.

sIL-2R and NSE were measured in 24 patients with small cell carcinoma (NSCC) of the lung, in 25 patients with non small cell carcinoma (NSCC) and in 20 controls matched for age, sex and smoking habits. Significantly elevated values of sIL-2R and NSE were found in the SCC group (mean +/- SEM: 2103 +/- 314.4 U/ml and 44.5 +/- 7.3 ng/ml respectively), compared to those in the NSCC group (1079 +/- 104.5 U/ml and 3.64 +/- 0.8 ng/ml, p < 10(-7) respectively) and to controls (561 +/- 44.6 U/ml and 1.7 +/- 0.3 ng/ml p < 10(-5). In the SCC group, 83.3% of sIL-2R and 87.5% of NSE values were above cut-off (900 U/ml and 10 ng/ml respectively), while in the NSCC group, 48% of sIL-2R and only 8% of NSE values were above cut-off. In the controls, all values of both parameters were below cut-off. The results suggest that sIL-2R and NSE in concurrent measurements may help in decision making as regards treatment and prognosis.

Cytokines in gynecological cancer.

BACKGROUND: Cytokines are considered as part of host defence to infection or injury. MATERIAL AND METHODS: Pretreatment values of TNF and sIL-2R were measured in 132 women with a) ovarian carcinoma (n = 25), b) breast cancer (n = 20), c) endometrial cancer (n = 15), d) cervical squamous cell carcinoma (n = 19), e) cervical adenocarcinoma (n = 11) and f) benign gynecological diseases (n = 42) in order to evaluate whether these cytokines could be useful in the discrimination of malignant from benign gynecological diseases. RESULTS: Both TNF and sIL-2R were significantly higher in all cancer groups together (mean +/- SD: 30 +/- 11 pg/mL and 1293 +/- 465 U/mL respectively), than those in the benign group (16.0 +/- 6 pg/mL and 626 +/- 233 U/mL, respectively; p < 0.0001), while no significant differences were found for TNF and sIL-2R values in the five cancer groups. Significantly higher cytokine values were measured in the advanced stage diseases (33 +/- 11 pg/mL and 1705 +/- 192 U/mL), than those in the limited cancer (26 +/- 12 pg/mL, p < 0.05 and 916(521 U/mL, p < 0.0001). CONCLUSIONS: Our results suggest that, cytokines may be useful in the discrimination of malignant from benign gynecological diseases and in monitoring tumor activity in patients early in the malignancy process.

A comparative study of serum alpha-beta A immunoreactive inhibin and tumor-associated antigens CA125 and CEA in ovarian cancer.

alpha-i.r Inhibin, has been recently proposed as a useful tumor marker for mucinous ovarian carcinomas (Ca), as the widely used tumor marker for ovarian malignancies, CA125 is efficient only in nonmucinous ovarian Ca, and, together with CEA, fails to detect minimal disease and show long half-life in serum after successful surgery. Moreover, conflicting evidence has been reported as to whether inhibin in ovarian malignancies is the biologically active dimer alpha-beta A inhibin or the inactive free alpha-subunits and inhibin precursors. Serum alpha-beta A i.r inhibin. CA125 and CEA were measured preoperatively and 8 days postoperatively in 39 postmenopausal patients with ovarian cancer (13 mucinous, 15 serous and 11 different other ovarian Ca) in comparison with 20 age-matched healthy women (Controls), 18 patients with benign ovarian tumors and 10 patients with nonovarian gynecological malignancies. Serum alpha-beta A i.r inhibin values were very low in controls (0.121 U/ml; 0.060-0.250) while they were greatly elevated in both benign (67% sensitivity) and malignant ovarian tumors (100% sensitivity in mucinous Ca, 80% in serous and 90.9% in other ovarian Ca, taken as cut-off level the maximum value in Controls, 0.250 U/ml). In contrast, in non-ovarian malignancies no increased values of alpha-beta A inhibin were found (0% sensitivity). Our results on the sensitivity of CA125 and CEA are in agreement with previous studies. After successful surgery the very high concentrations of alpha-beta A i.r. inhibin were reduced very rapidly (8 days) to normal postmenopausal values in contrast to those of CA125 and CEA, that remained elevated. Serum alpha-beta A i.r inhibin seems to be very useful in monitoring after treatment the patients with any type of ovarian malignancy and specifically those with mucinous ovarian cancer.

Tissue polypeptide specific antigen (TPS) throughout normal pregnancy.

AIM: TPS concentrations were measured throughout normal pregnancy in maternal serum (MS) and amniotic fluid (AF), in order to evaluate the usefulness of TPS in the follow-up of pregnancy breast cancer patients. PATIENTS AND METHODS: Following informed consent, 30 pregnant women during the 2nd trimester, 28 during the 3rd and 26 at parturition were included in the study. For comparison, 28 women in the 1st trimester and 28 healthy, non pregnant women (controls) were also studied. Both MS and AF antigen values were measured by an enzyme immunoassay (BEKI Diagnostics). RESULTS: Maternal serum TPS concentrations increased significantly with gestational age (p < 0.0001), being significantly higher in the 3rd trimester and during labor than those in the controls (p < 0.0001). Amniotic fluid TPS values were markedly elevated, compared with those in MS (p < 0.0001, paired-t-test), declining significantly from the 2nd to the 3rd trimester (p < 0.0015) and labor. Both MS and AF TPS values during labor depended on the mode of delivery, being higher in the cases terminated by vaginal delivery, compared to those by elective cesarean section. CONCLUSION: Maternal serum TPS values are influenced significantly by pregnancy, and thus, this antigen, as tumor marker seems to be reliable only during early pregnancy.

Breast cancer markers during normal pregnancy.

AIM: To measure MCA and CA153 concentrations in maternal serum (MS) and amniotic fluid (AF) paired samples during normal pregnancy, in order to evaluate the usefulness of these markers in monitoring pregnant patients with a history of breast cancer. PATIENTS AND METHODS: Serum and AF MCA and CA153 values were measured in 20 pregnant women during the 1st trimester, 29 cases in the 2nd, 26 in the 3rd and 20 at parturition and compared with those of 20 healthy, age-matched, non pregnant women (controls). RESULTS: MS values of MCA increased significantly with gestational age (p < 0.0001), being higher in the 3rd trimester and in labor than in control values (p < 0.0001). MCA values in AF were remarkably higher than those in MS and increased significantly with advancing gestation (p < 0.0001). In contrast, CA153 values in AF, which were marginally higher than in MS, did not differ significantly with the progression of pregnancy. CONCLUSIONS: Maternal serum MCA values are significantly influenced during pregnancy. Thus, this marker seems to be reliable only during early pregnancy. In contrast, CA153 remains a useful marker in monitoring pregnant breast cancer patients.

Homocysteine and folate levels in postmenopausal women.

OBJECTIVES: To assess total homocysteine (tHcy) and folate levels in postmenopausal women and investigate whether age, menopause duration, kind of menopause and tobacco use had an effect on these levels. METHODS: Total homocysteine and folate levels were measured in fasting blood samples of 200 postmenopausal women with normal thyroid and renal function tests. Patients were not receiving vitamins or hormone replacement therapy. RESULTS: Total homocysteine levels increased significantly after 60 years while folate levels showed a decrease trend after 65 years. Menopause duration had no effect on folate levels and increased significantly tHcy levels after >180 months duration. The kind of menopause did not influence tHcy and folate levels. Tobacco use reduced significantly folate levels. CONCLUSIONS: Age seems to be the principal factor influencing tHcy levels. We believe that decreased folate levels also reflect an age-associated inadequate dietary intake. Tobacco use did not alter tHcy levels; however, we found smoking to lower folate levels.

Serum soluble E- and L-selectin in the very early neonatal period.

Both E- and L-selectin are cell adhesion molecules. E-selectin is expressed by activated endothelial cells, whereas L-selectin by quiescent leukocytes and is rapidly cleaved off after activation. Both selectins take part in the first step of the 'adhesion cascade', the 'rolling of leukocytes', leading to the extravasation of the white cells to the sites of inflammation, infection or damage. For this reason their soluble forms (sE- and sL-selectin, respectively), are considered early and reliable markers of the immune activation and response. Moreover, sE-selectin has been reported to be a potent angiogenic factor and a reliable marker of infection and sepsis in neonates, as well as endothelial activation, while sL-selectin of the leukocyte function and maturity. Following informed maternal consent, we evaluated prospectively by ELISA, sE- and sL-selectin in the serum of 40 (19 females, 21 males), healthy, term, infection-free neonates, on the second and fifth day of life, and compared them with the respective values in 20 healthy adults (10 females, 10 males), with the purpose of examining the pattern of their values in the early postpartum days, and to establish reference values for both selectins. Values (mean+/-S.D.) of sE-selectin both on the second (139+/-48 ng/ml) and fifth day of life (111+/-35 ng/ml) were found to be highly increased, as compared with those in controls (48+/-13 ng/ml; P<4 x 10(-11) and P<4 x 10(-10), respectively), while sL-selectin values on both the second (674+/-223 ng/ml) and the fifth day of life (684+/-221 ng/ml), were significantly lower than those in controls (938+/-181 ng/ml); P<0.0001 and P<0.0003, respectively). A significant decrease was noted in sE-selectin values, from the second to the fifth day of life (P<10(-7)), while sL-selectin values showed no significant change in the same time interval. A strong correlation was found between values on the second and the fifth day of life of both sE- and sL-selectin (r(P)=0.885 and r(P)=0.813, respectively; P<0.00001). Neonatal values of both sE- and sL-selectin on the second or on the fifth day of life, did not depend on the perinatal factors, neonatal sex, or birth weight, mode of delivery, and maternal age or parity. In conclusion, in the very early neonatal period, our findings of highly increased sE-selectin, while low sL-selectin, suggest an immune and more specifically endothelial activation and an immature and decreased leukocyte function.

Patterns of inflammatory cytokine serum concentrations during the perinatal period.

Inflammatory cytokines interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured in the serum of healthy, term neonates on the first (N1), fifth (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and in adult controls. All three cytokines were significantly elevated in N1 and N5, compared with those in UC and adults (P < 0.0001). IL-1beta and IL-6 declined significantly from N1 to N40 (P < 0.0001), while TNF-alpha increased significantly from N1 to N5 and declined thereafter. TNF-alpha values in UC were significantly higher than in adults, but lower than in N40 (P < 0.0001), while IL-1beta and IL-6 values in UC did not differ from those in N40 and in adults. IL-1beta and IL-6, but not TNF-alpha values in MS were significantly higher than those in controls (P < 0.0001). IL-1beta values in MS were significantly higher than those in N1 (P < 0.0001), while those of IL-6 and TNF-alpha were significantly lower (P < 0.0001). Moreover, IL- 1beta values were dependent on the mode of delivery in N1 (P < 0.001), in MS (P < 0.02) and in UC (0.03), while IL-1beta and TNF-alpha values in N1 were strongly interrelated (r = 0.7; P < 0.01). In conclusion, the increased values of IL-1beta, IL-6 and TNF-alpha during the perinatal period might reflect a newborn immune response to the stress of delivery and to environmental changes after birth.

A comparative study of serum soluble vascular cell adhesion molecule-1 and soluble intercellular adhesion molecule-1 in preeclampsia.

OBJECTIVES: Maternal serum soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) were evaluated in preeclampsia to investigate whether these molecules could be helpful with regard to this pregnancy complication. STUDY DESIGN: The study population was composed of 30 preeclamptic patients with a mean gestational age of 35.5 +/- 4.6 weeks and 20 age-matched and gestational age-matched normotensive uncomplicated pregnancies (controls). Blood samples from 7 of the 30 preeclamptic patients and 15 of the 20 controls in the second trimester were also analyzed. Data were analyzed by parametric methods. RESULTS: Significantly higher maternal serum sVCAM-1 levels were found in both groups of preeclamptic patients with and without fetal growth restriction (981 +/- 145 ng/ml; n = 13; p < 0.0005 and 846 +/- 84 ng/ml; p < 0.02, respectively) compared with controls (668 +/- 186 ng/ml). In contrast, no significant difference was found in maternal serum sICAM-1 levels between preeclamptic and normotensive pregnancies, or in both adhesion molecules (1) in the controls between second and third trimester samples and (2) in the second trimester between pregnant women who developed preeclampsia later and gestational age-matched controls. CONCLUSION: These findings show a selective significant elevation of maternal serum sVCAM-1 in preeclampsia, with the highest values in cases complicated with fetal growth restriction, perhaps reflecting its angiogenic function. Hence, sVCAM-1 could be helpful in the diagnosis of this fetal complication in preeclampsia.

Hormonal patterns in a successful pregnancy of a patient with late-onset 21-OH deficiency taking methylprednisolone; a case report.

A successful pregnancy of a young woman with late-onset congenital adrenal hyperplasia (LOCAH) is reported. Exogenous glucocorticoids are the most commonly used regimen in such cases both for suppression of adrenal overstimulation and avoiding masculinization of a female fetus. In our LOCAH patient methylprednisolone has been used for treatment. We present the management and the outcome of this pregnancy, as well as the hormonal follow-up.

Hormonal and biochemical parameters in polyhydramnios.

Fifteen consecutive cases of polyhydramnios (PH) out of a total number of 8806 deliveries performed between the 28th and the 41st week of pregnancy were investigated during the period from 1979 to 1985. Three cases of acute PH and 12 cases of chronic PH of which 10 were idiopathic were distinguished. From the time the clinical diagnosis was established until delivery, maternal serum and amniotic fluid alpha-fetoprotein (AFP) and prolactin (PRL), as well as maternal serum oestrogens (OT), placental lactogen (HPL), chorionic gonadotropin (hCG) and pregnancy-specific beta 1-glycoprotein (SP1), were studied. A very high increase of maternal serum AFP in all the cases of PH was observed (p less than 0.001) and was associated with the high degree of risk for obstetrical complications, while, on the other hand, amniotic fluid AFP was increased only in PH associated with congenital abnormalities of the fetus. Maternal serum PRL was not different from normal values (p greater than 0.2), while amniotic fluid PRL was lower in all the cases of chronic idiopathic polyhydramnios studied. The protein hormones and the oestrogens showed a discrepancy in their elevation, according to the kind of PH, the outcome of pregnancy, and the condition of the infant at birth.

Vaginal fluid prolactin: a reliable marker for the diagnosis of prematurely ruptured membranes. Comparison with vaginal fluid alpha-fetoprotein and placental lactogen.

The aim of this study is the evaluation of the reliability of vaginal fluid (VF) prolactin (PRL) for detecting prematurely ruptured membranes (PROM) and the comparison of this marker with vaginal fluid alpha-fetoprotein (AFP) and placental lactogen (HPL). In 21 pregnant women with recent or prolonged PROM from 20 to 41 weeks' gestation, in whom intact membranes were never found subsequently VF- and MS-PRL, -AFP and -HPL were measured by enzyme immunoassays, which are sensitive and very rapid. The same markers were also measured in MS, VF and urine samples (U) in 12 pregnant women of the same gestational age, without PROM, in whom the membranes were ruptured later during labor. In PROM, independently of prematurity and duration of PROM VF-PRL levels were significantly higher (2-10-fold) than the paired MS-PRL (p less than 0.0001) and ranged from 130 to 2315 ng/ml. In contrast, VF-PRL and urine PRL concentrations in pregnancies without PROM were very low or undetectable (range: 0-5 ng/ml and 0.15-1 ng/ml, respectively). Vaginal fluid AFP values in PROM from 20th to the 33rd week of pregnancy were significantly higher (5-50-fold) than the paired MS-AFP (p less than 0.01) and ranged from 103 to 5500 ng/ml. In PROM after the 33rd week of pregnancy, VF-AFP values were either lower (1/3), or equal to, or even higher (up to 2-fold) than MS-PRL. On the contrary in pregnancies with intact membranes, VF-AFP were always less than 9 ng/ml and urine AFP was undetectable (range: 0.2-1.1 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Expression of CEA, CA-125 and SCC antigen by biological fluids associated with pregnancy.

Carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125) and squamous cell carcinoma (SCC) antigen were measured in 56 full-termed pregnancies by enzyme-immunoassays (EIA-MEIA). The measurements were done in maternal serum (MS), umbilical cord blood (UCB) and amniotic fluid (AF) samples, during delivery. Very high antigen levels were found in AF samples (median: CEA = 124 ng/ml; CA-125 = 710 U/ml; SCC = 710 ng/ml) compared to UCB and MS. CEA and SCC showed significantly lower values in MS (0.6 and 1.7 ng/ml, respectively) than in UCB (1.6 ng/ml, P = 7.7 x 10(-9); 3.55 ng/ml, P = 6.5 x 10(-6), respectively), while CA-125 had significantly higher values in MS (6 U/ml) than in UCB (0.0 U/ml, P = 17 x 10(-6); Wilcoxon paired test). All CEA values in MS were below cut-off (less than or equal to 5 ng/ml), while 10% of CA-125 and 30% of SCC values were above cut-off (less than or equal to 35 U/ml and less than or equal to 2.5 ng/ml, respectively). Amniotic fluid CEA with meconium had higher values (P = 0.0002), while the highest CA-125 values in AF samples were found in primiparae (P = 0.02). Moreover SCC in AF samples from vaginal delivered pregnancies showed significantly higher values, compared to those from cesarean section (P = 4.2 x 10(-7); Mann-Whitney U-test). Thus, our findings suggest that pregnancy has an influence on maternal serum SCC and CA-125 values, while CEA is independent of gestation and seems to conserve its diagnostic value during pregnancy as well.

Serum levels of steroid and placental protein hormones in ectopic pregnancy.

UNLABELLED: The hormonal profiles of extra-uterine pregnancies (EP) were compared with the normal intra-uterine pregnancies (IUP), and threatened abortions (TA) of good outcome. In 45 cases of EP confirmed histologically, maternal serum human chorionic gonadotropin (hCG), pregnancy specific beta 1-glycoprotein (SP1), 17 beta-estradiol (E2) and progesterone (P) were measured serially before treatment by enzyme immunoassays (EIA). The same hormones were also determined in the control groups, 26 with normal IUP and 24 with TA. All four hormone levels in EP were significantly lower (P less than 0.01-P less than 0.0001) than in normal pregnancies and threatened abortions of matched gestational age except the hCG and E2 in the fifth week of pregnancy. The mean values of E2 and P were found in the normal levels of luteal phase or slightly over them (8th-9th and 9th-10th weeks, respectively). No increase in the hormonal profiles of the above two steroids was noticed between 5 and 10 weeks' gestation in EP. IN CONCLUSION: (a) The significantly lower values of hCG and SP1 in EP were confirmed; (b) the serial and concurrent hormonal measurements assure the verification of EP and the differentiation from normal IUP and TA of good outcome; (c) the ectopic implantation of trophoblast critically reduces its vitability to hCG and SP1 synthesis and it can only partially compensate for the reduction of corpus luteum function.

Tumour-associated antigens, CEA, CA 125 and SCC in serum and follicular fluid of stimulated and unstimulated cycles.

Serum and follicular fluid levels of CEA, CA 125 and SCC of women participating in an IVF program, in 42 cycles stimulated with GnRH-a and gonadotropins and in 26 unstimulated cycles triggered with HCG, were evaluated and compared with (a) steroid and gonadotropin levels, (b) the results of IVF, and (c) serum values in a control group of women with spontaneous normal ovulatory cycles. In the control group, serum antigens did not vary significantly during the 3 phases of the cycle. In stimulated cycles the median values in serum were 0.7 ng/ml (range, 0.0-2.1) for CEA, 14.0 U/ml (3.3-32.4) for CA 125 and 2.05 ng/ml (1.1-17.8) for SCC, whereas the median values in follicular fluid were 0.6 (0.0-27.9), 21.5 (0-670) and 21.4 (1-360), respectively. In unstimulated cycles the median values and ranges in serum were 0.9 (0.4-3.9), 12.1 (4.8-63.4) and 1.85 (0.7-4.4), respectively, whereas in follicular fluid they were 2.9 (0.4-180.7), 32 (1.7-600) and 231 (10.8-904). Different follicles of the same patients in stimulated cycles showed a wide divergence for all three antigens. In unstimulated cycles all three antigens in follicular fluid were strongly-correlated and a significant inverse correlation was observed between LH and both CA 125 and SCC in serum. In either group of cycles, no significant relationship was found between any serum or follicular fluid antigen and estradiol or testosterone, pregnancy rate, or oocyte quality and fertilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Mucin-like carcinoma-associated antigen (MCA) during normal pregnancy.

OBJECTIVE: To assess the usefulness of Mucin-like carcinoma-associated antigen (MCA) in monitoring pregnant patients with breast cancer. STUDY DESIGN: Maternal serum (MS) and amniotic fluid (AF) antigen values were measured by an enzyme immunoassay in 30 pregnant women during the second trimester, in 28 during the third and in 26 at parturition. Sera only from 26 women in the first trimester and from 26 healthy, non-pregnant women (controls) were also analyzed. RESULTS: Maternal serum MCA concentrations increased significantly with gestational age (p<0.0001). The frequency of elevated serum values was 5% in the first, 35% in the second and 100% in the third trimester and at parturition. Antigen values in AF were markedly higher than those in MS (p<0.0001) and increased also significantly with advancing gestation (p<0.0001). A strong correlation was observed between MS and AF antigen values (r=0.77, p<0.0001). Maternal serum values at parturition were dependent on the mode of delivery, being higher in the cases who delivered vaginally, compared to those delivered by elective caesarean section (p<0.006). CONCLUSION: Our data suggest that pregnancy affects significantly maternal serum MCA. Consequently, MCA seems to be a non-reliable marker in monitoring pregnant patients.

hCG regression after treatment in active and regressed extrauterine pregnancies.

The regression of hCG levels was studied in the maternal serum of 15 cases of tubal pregnancies (6 regressed and 9 active). Measurements of the hCG values were made before the operation and after 12, 24, 48, 72, 96, 120 and 192 hours. The mean hCG values in the groups of the regressed and active cases, before treatment, were 479.4 +/- 266.4 mIU/ml and 6334.0 +/- 932.1 mIU/ml, and after 192 h 4.8 +/- 0.4 mIU/ml and 115.8 +/- 37.9 mIU/ml, respectively. The hCG mean values in both groups showed the same exponential regression pattern and the percentage decrease in the hormone level in the period of time between 0 and 192 h was 98%. The mean values of the hormone in both groups showed significant differences (p less than 0.001) during the whole time interval observed.

Maternal serum total cortisol levels in normal and pathologic pregnancies.

The effect of pregnancy on maternal serum total cortisol (MSFT) was studied systematically in the course of 90 normal pregnancies (n = 204). Moreover, the evaluation of MSFT determinations in abnormal pregnancies, intrauterine growth retardation (IUGR) and obstetrical complications, premature rupture of the membranes (PROM), premature delivery (PD), and full term pregnancies with post maturity syndrome (PMS) were also investigated. MSFT was measured by an enzyme immunoassay. Gradual increase in MSFT was found from the 6th week of pregnancy to the 40th week of pregnancy and a sharp rise was noted during the last 2 weeks before the onset of labor (P less than 0.002). In IUGR, MSFT was significantly lower (P less than 0.001). In the cases of PROM and PD, MSFT was highly elevated (P less than 0.0001), independently of the gestational age. In pregnancies with well documented PMS, MSFT was much lower than in normal full term pregnancies with even a downward trend in serial determinations (P less than 0.0001).