The transfer and metabolism of corticosteroids in the perfused human placenta.

The transfer and metabolism of cortisol, prednisolone, betamethasone, and dexamethasone were investigated in vitro in the perfused human placenta. Maternal and fetal circuits were established but the steroid was added to the former only. The clearance expressed as a fraction of the antipyrine transfer rate varied from 0.27 to 0.50, but there were no significant differences among the four steroids. All the steroids were metabolized extensively to their respective 11-ketosteroids and again there were no material differences among the steroids. The metabolic conversions of dexamethasone and betamethasone were far greater in the perfused placenta than in minced placenta. From the standpoint of placental transfer and metabolism, as observed in the perfusion studies, none of the four corticosteroids offers a decisive advantage in the antepartum maturation of the fetal pulmonary surfactant system.