Conversion of dehydroepiandrosterone sulphate to oestrogens in intraphepatic cholestasis and other complications of pregnancy.

The aim of the present study was to determine whether pregnancy complications themselves influence the conversion rate of dehydroepiandrosterone sulphate (DHAS) to oestrogens during pregnancy. 100 mg DHAS was given intravenously to seven women with intrahepatic cholestasis of pregnancy, nine women with preeclampsia, nine diabetics, ten with twins and eight women with normal pregnancy between 31--40 weeks of gestation. Serum oestradiol (E2) and oestriol (E3) were measured with specific radioimmunoassays before and 1--5 h after DHAS injections. A significant oestradiol elevation following DHAS was similar in each group. By contrast there was an oestriol elevation (P less than 0.05) only in intrahepatic cholestasis of pregnancy. The results indicate that: (1) pregnancy complication itself does not effect the conversion rate of DHAS to oestradiol, (2) in patients with intrahepatic cholestasis there is a disturbed E3 metabolism which may be due to an increased placental permeability to exogenous DHAS or to a decreased metabolism of E3 by maternal liver.