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Selye's theory of adaptation diseases (1946, 1950) and the investigations inspired by it have shed a great deal of additional light on the function of the adrenal cortex in pregnancy and especially in toxaemia of late pregnancy. The frequently advanced assumptions of increased or disturbed corticoid secretion in toxaemia (Parviainen et al., 1949) have been corroborated by most of the subsequent hormonal studies (Tobian, 1949, Parviainen et al., 1950, Staemmler, 1952, 1953, Goutard, 1953, Devis, 1954, Milliez & Tritel, 1954, Hughes et al., 1954, Rivière et al., 1954, Venning et al., 1954), although the reliability of the hormonal analysis in particular has been criticized (Devis, 1954, Pigeaud et al., 1954). Many indirect tests, such as the eosinophil count (Ferguson, 1951) and corticotrophin and adrenaline tests (Soiva, 1953) have given similar indications regarding corticoid secretion in toxaemia. Observations on the same lines have also been made in investigations on electrolyte

Many findings in our previous investigations (Parviainen et al., 1949, 1950 a - h, 1951 a - g) seemed to suggest that cortisone might eventually be of some use in the treatment of late toxaemia of pregnancy. The earlier (e. g. Soffer, 1949) supposed capacity of cortisone to increase sodium excretion and its inhibiting effect on the pathological changes produced by desoxycorticosterone acetate (Selye, 1950 a - b, Woodbury, Rosenberg & Sayers, 1950), and further, its possible beneficial effect in some cases of nephrosis (Deming & Luetscher, 1950) and in hypertension (Perera et al., 1944 - 1950) seemed to us to be of value in toxaemia, when this disease appeared as a syndrome of hyperadaptation to the stress of pregnancy (Parviainen et al., 1949).Since the mode of action of cortisone and its true effects have not yet been sufficiently explained ( e. g. according to the review of Ingle, 1950), we decided to study

In previous investigations (Parviainen et al., 1949, 1950, Soiva, 1953, Soiva & Parviainen, 1955) attempts were made to elucidate the significance of hormonal factors, especially of corticosteroids, in the aetiology of toxaemia of late pregnancy, particularly in relation to the theory of adaptation diseases of Selye(1946, 1950). Similar conclusions on the function of the adrenal cortex during pregnancy and in toxaemia of pregnancy have been presented by several other authors (e. g. Gemzell, 1953, 1956, Venning et al., 1954, Elert, 1954, Mastboom, 1955, Raab et al., 1956), but it has not always been possible to demonstrate any differences in adrenocortical function between normal pregnants and toxaemia patients (e.g. Martin & Mills, 1956). In this connection mechanical factors have been held to be more important than hormonal factors (Dieckmann & Pottinger, 1955).When studying the function of the adrenal cortex both direct hormone determinations and indirect methods have been employed.

Vaginal smears of rats taken during normal and disturbed pregnancies have been examined after Shorr staining. The vaginal smears of control rats, the pregnancies of which progressed normally, contained few cells and had layer indices approaching zero. The result of a disturbance of the pregnancy by audiogenic and visual stimulation was abortion in three rats, but in the remaining eleven, pregnancy progressed to term. In nearly all the latter animals, numerous superficial and acidophilic cells were found in the vaginal smears and the layer indices were 70—75 per cent in many of the smears.

Four women who had been pregnant for 17–24 weeks and whose pregnancies had been interrupted with simultaneous sterilisation because of chronic diseases, were given 10–20 μc of progesterone-4-14C intravenously. The ether-soluble radioactive material in the plasma of the mothers decreased so rapidly that only one per cent of the original radioactivity remained after 10 minutes. Two to four specimens of blood were taken from each foetus in utero 2–15 minutes after the injection. Every specimen was found to contain an ether-soluble radioactive material. The radioactivity of the foetal plasma increased gradually and 5–10 minutes after the injection it reached the radioactivity level in the plasma of the mother.

We have previously shown that corticoids probably play an important part in the aetiology of toxaemia (Parviainen, Soiva & Ehrnroot, 1949, 1950 a, b, c, d). Our investigations into urinary corticosteroid excretion, which were carried out by the method of Heardand Sobel(Parviainen, Soiva & Vartiainen, 1950), support this opinion. Further evidence is also given by the more extensive hormone determinations of Devis & Devis-van den Eeckhoudt(1949). As we were unable to carry out accurate corticoid determinations, we have studied the adrenocortical function in cases of toxaemia by the so-called indirect methods (cf. Parviainen & Pärnänen, 1950). The oral glucose tolerance test was chosen as our attempts to obtain ACTH were unsuccessful.Pincus et al.(1946) found that the glucose tolerance test caused changes in the white blood count similar to those found in normal human subjects exposed to stress (e. g. raised temperature and psychomotor stress). The

It has been said that the 40 weeks of pregnancy are a period of intensified activity of the hypophysis and the adrenal cortex (Caton et al., 1951). Increased or disturbed corticoid secretion has also been considered of significance in toxaemia of late pregnancy (Selye, 1946, Parviainen et al., 1949, 1950, 1951, Garrett, 1950, Garm, 1950, Ordman, 1950, Masson et al., 1951, Mastboom, 1952, a. o.). A possibility of studying the reserve power of the adrenal cortex is afforded by the ACTH test (Thorn et al., 1948) and partly also by the adrenaline test (e. g. Bliss et al., 1951). So far such tests have been carried out in only a few cases during pregnancy and in toxaemia of late pregnancy (Dworetsky et al., 1950, Ferguson, 1951, Caton et al., 1951). The results have been divergent. Hence it was decided to study the response of eosinophils to the ACTH and adrenaline

The effect of orally administered 17a-ethyl-17ß-hydroxy-19-norandrost-4-en-3-one (75 mg daily during 8 days) on the urinary excretion of 17-ketosteroids, total 17-hydroxycorticosteroids and uropepsin and on the gastric secretory activity has been studied in 10 male patients with peptic ulcers. The excretion of 17-ketosteroids was significantly reduced, but the excretion of total 17-hydroxycorticosteroids and uropepsin and gastric secretory activity were not affected by the treatment.

The permeability of the guinea pig placenta to progesterone was studied by injecting progesterone-4-14C intravenously into seven pregnant guinea pigs, and determining the levels of radioactivity in the plasma samples taken from the mothers and foetuses during 15 minutes after the injection. The ratio of the levels of radioactivity in the plasma of the foetus to the level in the plasma of the mother increased with time. In three experiments progesterone-4-14C was injected into the umbilical vein of one of the foetuses in the uterus. Radioactivity was measured in the plasma samples that were taken from the mother from 2 to 23 minutes after the injection. A low level of radioactivity was also found in some of the plasma samples taken from the other foetuses. These observations show that radioactive progesterone or its metabolites pass through the guinea pig placenta in both directions.