Low Urinary Estriol During Pregnancy Caused by Isolated Fetal Acth‐deficiency

Zachmann, M., Girard, J., Duc, G., Illig, R. and Prader, A. (Departments of Pediatrics, Universities of Zurich and Basel, Switzerland). Low urinary estriol during pregnancy caused by isolated fetal ACTH‐deficiency. Acta Paediatr Scand, Suppl. 277: 26, 1979.—In a 34‐year‐old pregnant woman, serum HPL and urinary HCG were normal, but urinary estriol was repeatedly low. A normal boy was delivered after 38 weeks gestation. During the neonatal period, he had hypoglycemia, muscular hypotonia and transient hyperbilirubinemia. The ACTH‐test was normal, but the THS‐response to metyrapone was low. Serum ACTH did not respond to insulin and metyrapone. Growth hormone, TSH and gonadotropin responses to stimuli were normal. Treatment with hydrocortisone resulted in disappearance of the symptoms. It is concluded that fetal ACTH‐deficiency is one of the specific endocrine causes of low maternal estriol.