Radioisotopic placentography requires accurate localization of the maternal component of placental circulation by detection of a circulating radionuclide confined to the maternal intravascular space. Sodium-24 chloride was the tracer first employed in placentography (2) but its rapid extravascular diffusion was disadvantageous. In 1957, iodine-131 labeled human serum albumin was found a preferable agent (5) and is presently the most widely used tracer. Inorganic I131 is released by metabolic degradation of radioiodinated albumin, however, and may also be present in small amounts in preparations of this radiopharmaceutical. Consequently, the administration of potassium iodide is mandatory to minimize radiation to fetal and maternal thyroid tissue. Subsequently, iodine 132 was recommended as the label for human serum albumin since the maternal and fetal radiation doses were thereby reduced (3). More recently, chromium-51 labeled erythrocytes have been employed in placentography (4). Chromium-51 labeled human serum albumin has recently become available; its chief use has been in studies of albumin metabolism and transenteric protein loss. An investigation was undertaken at the Columbia-Presbyterian Medical Center to determine the possible function of this material as an agent for placental localization. Materials and Methods 1. Sterile, hepatitis-free human serum albumin2 labeled with chromium-51 in high specific activity was diluted with normal saline to a concentration of approximately 20 μc per ml. Under sterile conditions 35 μc of this material was administered intravenously to each of 12 pregnant women in the third trimester of pregnancy. It was thought that placental localization in these cases would prove useful in clinical management. 2. After an intravascular mixing time of ten minutes a series of external counts was obtained with a collimated 2-in. scintillation crystal-decade scaler system. a. The point of maximum precordial radioactivity, corresponding to the cardiac blood pool, was located on the anterior thorax and the one-minute net count rate was measured. b. The anterior abdominal wall was divided into 10 and each flank into 2 counting areas. One-minute net counts were sequentially obtained over each counting area. The surface of the collimator was placed normal to the skin except in the flank areas, where it was angled slightly posteriorly. On completion, the precordial area was again counted for one minute. 3. Each abdominal and flank net count was expressed as a percentage of the mean precordial net count. The abdominal or flank areas showing the highest percentage counting rate were considered to correspond to the placental site. 4. In 2 cases, samples of maternal and cord blood were obtained immediately after delivery, the cord first being washed and the initial milliliter of cord blood being discarded.
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