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Differential evaluation of the fetoplacental unit in patients with diabetes

  • N.A. Samaan
    Correspondence
    Reprint requests: Dr. N. A. Samaan, Chief, Section of Endocrinology, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, 6723 Bertner Ave., Houston, Texas 77025.
    Affiliations
    Section of Endocrinology, Department of Medicine The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    Department of Pathology, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    the Department of Obstetrics and Gynecology, Hermann Hospital Houston, Texas, USA
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  • H.S. Gallager
    Affiliations
    Section of Endocrinology, Department of Medicine The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    Department of Pathology, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    the Department of Obstetrics and Gynecology, Hermann Hospital Houston, Texas, USA
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  • W.A. McRoberts Jr.
    Affiliations
    Section of Endocrinology, Department of Medicine The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    Department of Pathology, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    the Department of Obstetrics and Gynecology, Hermann Hospital Houston, Texas, USA
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  • B. Holt
    Affiliations
    Section of Endocrinology, Department of Medicine The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    Department of Pathology, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute Houston, Texas, USA

    the Department of Obstetrics and Gynecology, Hermann Hospital Houston, Texas, USA
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      Abstract

      Plasma unconjugated estrone (E1), estradiol (E2), and estriol (E3) and 24 hóur urinary estriol levels were measured serially throughout the course of pregnancy in 11 normal and 16 diabetic patients. Eight of the babies of the diabetic patients survived; 2 died during the neonatal period, and 6 died in utero. Large-section histologic preparations of the placenta were studied in all patients. Our data indicate that the unconjugated E1 and E2 plasma levels may be of value in predicting the fetal outcome. The plasma unconjugated E3 levels are low in all diabetic patients regardless of the condition of the fetus. Therefore, plasma free estriol measurement is of little direct value in assessing pregnancy outcome. However, urinary estriol measurements correlated well with fetal survival. Placental sections showed significant changes in all the diabetic patients regardless of the degree of severity or the status of therapeutic control of the disease.
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