By John W. Reynolds (auth.), J. H. P. Jonxis M.D., H. K. A. Visser M.D., J. A. Troelstra M.D. (eds.)
The proposal of the foeto-placental unit as an built-in endocrine organ has been outlined lately through many in vivo stories on the seventeenth- twentieth week of gestation. A functioning foeto-placental unit is important for many of the elevated oestrogen creation of being pregnant and for the availability of glucocorticoids and aldosterone to the foetus. Neither the foetus nor the placenta by myself have the mandatory enzyme structures for the synthesis of those teams of steroids. although, while the foetus and placenta functionality as a unit, all the enzyme platforms are current for the synthesis of those steroids from circulating ldl cholesterol. The placenta, yet now not the mid-gestation foetal adrenal, can synthesize physiologically a great deal of pregnenolone from circulating ldl cholesterol. a part of the pregnenolone is switched over to progesterone within the placenta by way of the 3~-HSD process (absent within the foetus). The progesterone is transferred to the foetus the place it really is remodeled by way of C-II, C-17, C-18 and C-21 hydroxylases (all absent within the placenta) to cortisol, corticosterone and aldosterone. Pregnenolone transferred from the placenta to the foetus undergoes 171X-hydroxylation, part chain splitting and sulfurylation (absent within the placenta) and is switched over to DHAS. The DHAS may possibly suffer 161X-hydroxylation (absent within the placenta) within the foetal liver and be transported to the placenta as 161X-OH-DHAS. There it's subjected to a impartial steroid sulfatase (absent within the foetus) and is switched over to oestriol by way of motion of the 3~-HSD process and the aromatizing enzyme system.
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Extra resources for Aspects of Praematurity and Dysmaturity: Groningen 10–12 May 1967
Neurological examination 2. G. 3. X-Ray of the skull 4. Anatomical examination. This, of course, gives just a confirmation in cases terminated by death. Those 4 ways are fully described in various papers, in a movie (11), and finally, in the book Human Development (17). We will only here summarize and discuss the data published elsewhere. I. NEUROLOGICAL EXAMINATION S. SAINT-ANNE DARGASSIES (15) has used ANDRE THOMAS'S (16) technique originally described for the full-term newborn applying it to the premature infant.
Who likes to ask some questions to Dr. REYNOLDS? Dr. Sereni: Since oestriol is synthetized mostly by the foetus, as you have clearly shown, some obstetricians believe that frequent determinations in the maternal blood of the concentration of this compound might be taken as a good index of the clinical conditions of the foetus. In other words, a fall in maternal oestriol concentration should indicate foetal distress. Could you make a short comment on this point? Dr. Reynolds: Yes, the use of maternal oestriol blood levels as indicators of foetal viability or foetal health does make sense.
Reynolds: I would like to ask Dr. GRUENWALD a question. How frequently are completely normal but very small placentas associated with intra-uterine growth retardation compared with apparently the more common circumstance of microscopically abnormal placentas being associated with such retarded infants. Dr. Gruenwald: That is not easy to answer because if we find a small placenta we have no right to assume that the foetus is small because the placenta is small. The placenta as far as its fixed tissue is concerned, it is an organ of the foetus and a small foetus can have a small placenta just as it has a smaller liver and smaller kidneys and smaller feet.
Aspects of Praematurity and Dysmaturity: Groningen 10–12 May 1967 by John W. Reynolds (auth.), J. H. P. Jonxis M.D., H. K. A. Visser M.D., J. A. Troelstra M.D. (eds.)