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NAGUIB A. SAMAAN, WILLIAM A. McROBERTS, JULIAN P. SMITH, LARRY G. MYERS, Metabolic Changes in Women with Trophoblastic Disease and with Intrauterine Fetal Death Compared with Metabolic Changes During Normal Pregnancy, The Journal of Clinical Endocrinology & Metabolism, Volume 33, Issue 3, 1 September 1971, Pages 521–529, https://doi.org/10.1210/jcem-33-3-521
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Abstract
The metabolic patterns during each trimester of pregnancy in response to arginine and oral glucose tolerance (GTT) were investigated and repeated postpartum. In order to assess the effect of the various hormones produced during pregnancy in terms of their relative roles on glucose, on insulin (IRI), and on growth hormone (HGH) levels, five patients with trophoblastic disease were studied during arginine and oral GTT and the results were compared with those found during normal pregnancy as well as in nonpregnant subjects. Similar studies were also done in four patients with gestational diabetes and intrauterine fetal death late in the third trimester and were compared to those found in ten patients with gestational diabetes at term who delivered viable infants. Our studies showed that the increase of IRI levels during arginine and oral GTT and the diminished HGH rise seen during pregnancy after intravenous arginine stimulation could not be attributed to the effect of human chorionic gonadotropic hormone (HCG). The blood sugar, IRI, and HGH changes in gestational diabetics with intrauterine fetal death were similar to those seen during pregnancies with live fetus in spite of low levels of urinary estriol in all patients and low levels of pregnanediol in two. Total plasma cortisol in pregnancies with an intrauterine fetal death were similar to that found in the postpartum period while the human placental lactogen (HPL) sometimes referred to as human chorionic somatomammotropin (HCS) was within the range seen in gestational diabetics who had living fetuses. Our investigations suggest that HPL has a significant metabolic role during pregnancy but the synergetic or antagonistic effects of other hormones of the fetoplacental unit await further study.
