Thyroxine, 3,5,3' -triiodothyronine and 3,3', 5' -triiodothyronine in human amniotic fluid: relationships between concentrations and turnover.

We have made estimates of the possible contributions of various routes of entry and disposal to the turnover of thyroxine (T4), 3,5,3'-triiodothyronine (T3) and 3,3',5'-triiodothyronine (reverse T3, rT3) in human amniotic fluid (AF). Our calculations suggest that, in normal pregnancy, AF T4 and T3 are derived mainly from the maternal circulation, and that their concentrations depend very largely on binding-protein concentrations. The majority of AF rT3 is unlikely to enter the amniotic sac directly from the maternal circulation, or from the fetal circulation by passive diffusion or fetal urinary excretion; however, our calculations are consistent with the hypothesis it is derived largely from inner-ring deiodination of T4 in the fetal membranes. We propose that the molar ratio of one AF iodothyronine to another may yield more information about fetal thyroid status than the total concentration of any single iodothyronine.