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Testing for levels of beta-human chorionic gonadotropin (hCG) and pregnancy-associated plasma protein A (PAPP-A) in the first trimester of pregnancy may be as accurate as second trimester tests to detect Down syndrome. Researchers analyzed blood samples taken from mothers in the first trimester from 22 Down syndrome and 483 normal pregnancies for levels of free beta-hCG and PAPP-A. Fifteen of the 22 Down syndrome cases were identified in the first trimester using these tests, a rate of 68.2% with a 5% false-positive rate. This rate of detection may be at least as sensitive as second trimester tests for Down syndrome. Detection rates were adjusted for the 11 Down syndrome cases involving mothers 35 years and older. Testing the mother's blood for alpha-fetoprotein in the first trimester may not produce accurate results.

A regulatory protein known as calcitonin gene-related peptide (CGRP) may not be involved in the development of preeclampsia. Preeclampsia is a serious complication of pregnancy involving high blood pressure and protein in the urine. Researchers compared the levels of CGRP in blood from mothers and fetuses and in placental tissue from preeclamptic pregnancies to those from normal pregnancies and to blood from women who were not pregnant. CGRP levels were similar among preeclamptic, normal pregnant, and nonpregnant women. CGRP levels in fetuses and in placental tissues were similar in preeclamptic and normal pregnancies. These findings differ from those from previous studies suggesting that CGRP levels are low in preeclamptic pregnancies.

Measuring blood levels of progesterone on days four and seven of the menstrual cycle may be an effective method for diagnosing luteal insufficiency. Progesterone is a hormone secreted by the corpus luteum, the yellow mass in the ovary formed by an ovarian follicle that has matured and discharged its egg. Blood levels of progesterone, luteinizing hormone and placenta protein 14 were measured daily during one menstrual cycle in 45 women between 22 and 49 years old with a regular menstrual cycle. Measurement of blood levels of progesterone on days four and seven of the menstrual cycle revealed that 39 women had normal luteal function and six women had luteal insufficiency. A single measurement of progesterone or placental protein 14 was not effective for diagnosing luteal insufficiency.

Pregnant women have elevated blood levels of the major basic protein of eosinophilic granules, which are storage compartments in eosinophils (a type of white blood cell). This protein has been found in the X cells of the placenta, the tissue that provides nourishment to the fetus. These X cells are located in the placental septa, wall-like structures that separate cavities, and cysts, sac-like structures. The number of septa and cysts vary with different placenta. The development of septa and cysts in the placenta is thought to be associated with the advancement of pregnancy and maturation of the fetus. The number of X cells, as reflected by the number of placental cysts and septa, should correlate with the blood levels of major basic protein. The relationship between the number of placental cysts and septa and blood levels of major basic protein was assessed. The results showed that blood levels of major basic protein correlated with the number of placental cysts, septa, and deposits of fibrin, a thin, white protein. The levels of major basic protein were not related to the placental weight. These findings suggest that major basic protein can serve as a marker for placental septa and cysts, and help in elucidating the function and role of X cells in the formation of placental cysts, septa, and fibrin deposits. (Consumer Summary produced by Reliance Medical Information, Inc.)

The immune system of the pregnant woman recognizes the fetus and does not reject it as though it were foreign tissue. It is likely that the maternal cells in closest proximity to the fetus, contained in the decidua (maternal tissue to which the placenta is attached), mediate this response. To learn more about the immune factors that these cells produce, studies were performed of tissue from women who underwent elective abortion (17), hysterectomy for benign conditions (9), or uncomplicated cesarean sections (5). The levels of mRNA associated with several factors were measured: IL-1-beta, a protein that stimulates the immune system; HLA-DR-alpha, a protein that forms a complex with foreign antigens to allow recognition by the immune system; and transforming growth factor-beta (TGF-B), a peptide that suppresses the immune system. Its levels would be expected to increase if the levels of the other two factors increased, to counteract the chances of rejection of foreign tissue. Results showed that the levels of mRNA for IL-1-beta, HLA-DR-alpha, and TGF-beta increased 20, 3, and 5 times, respectively, in uterine tissue from pregnant women, as compared with tissue from nonpregnant women. The magnitude of these increases varied according to the time in the menstrual cycle during which nonpregnant uterine tissue was taken, but significant increases were always associated with pregnancy. The amounts of these proteins in placental tissue are also reported and discussed. ''Immunotropism'' is the term used to describe the beneficial effects for the fetus when the maternal immune system reacts; many factors that are released as a consequence of that response stimulate placental growth. However, while this may be the case, IL-1B and HLA-DR are also involved in graft rejection, and the possibility exists that excess levels may be associated with repeated miscarriage and fetal growth retardation. (Consumer Summary produced by Reliance Medical Information, Inc.)

The secretory endometrial cells that line the inside of the uterus release a placental protein known as PP14. The amount of PP14 secreted changes during phases of the menstrual cycle. It has been found that the relative amount of PP14 secreted indicates the secretory activity of the endometrium. The amount of PP14 in the blood was used to measure protein secretion in 77 patients with endometriosis, the abnormal implantation of endometrial tissue, normally found inside the uterus, elsewhere in the body. The levels of PP14 were highest during the first four days and the lowest on days 5-20 of the menstrual cycle. Patients with severe endometriosis had higher levels of PP14 on the low days than patients with mild endometriosis, who had higher levels than the normal controls. There was overlap between the three groups. Treatment for endometriosis, which included surgical removal of diseased tissue alone or in combination with drug therapy using danazol or medroxyprogesterone, was found to lower PP14 concentrations. It is concluded that PP14 secretion is elevated in patients with endometriosis and treatment of the condition effectively lowers PP14.