Effect of dexamethasone on blood levels of ACTH, cortisol, progesterone, estradiol and estriol during late pregnancy.

Abstract

ABSTRACTCorticosteroids are used to prevent the respiratory distress syndrome of the premature newborn. In order to evaluate the effect of such treatment on maternal and fetal endocrine functions the circulation levels of ACTH, Cortisol, progesterone, estradiol and estriol were measured in 13 patients before, during and after three days of intramuscular dexamethasone treatment. ACTH was significantly lower in the first day of the treatment and Cortisol in all three days, indicating a significant suppression of the pituitary‐adrenal axis. The treatment did not effect placental steroid genesis, as seen in the unchanged level of progesterone. Estradiol and estriol levels decreased significantly during the days of the treatment. This was supposedly the result of a decrease in the production of C‐19 estrogen precursors, caused by the suppression of both maternal and fetal adrenals. Clinically, it is important to notice that during dexamethasone treatment estriol is not a reliable indicator of fetoplacental function and the blocking of the pituitary‐adrenal system ought to be borne in mind when planning operative delivery during such treatment.