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ADRENAL RESPONSE IN PREGNANCY TO LONG‐ACTING TETRACOSACTRIN

Plasma 11‐hydroxycorticosteroid (11‐OHCS) values were studied before and after an intramuscular injection of 1 mg. of long‐acting tetracosactrin in 8 patients in the second trimester of pregnancy, 9 patients in the third trimester, and 10 non‐pregnant control patients. Resting values in patients in the second and third trimesters of pregnancy were similar and were significantly higher than the values in non‐pregnant patients. At 6 hours and 10 hours after a tetracosactrin injection the increase in plasma 11‐OHCS values was significantly greater in pregnant patients than in controls. The shape of the response curve in pregnancy was different to that of the controls; in the non‐pregnant patients there was a steep rise at 3 hours with a plateau from 6 hours onwards while in the pregnant patients there was a peak between 6 and 10 hours with a more rapid subsequent decline. Plasma oestriol levels were not influenced by changes in plasma cortisol. The response of plasma 11‐OHCS levels to an injection of long‐acting tetracosactrin is considered to be a safe, simple and effective method of assessing adrenal function in pregnancy.