Does Administration of Diethylstilbestrol to Pregnant Women Result in Increased Output of Urinary Pregnanediol? ∗

Abstract

Summary and Conclusions

When diethylstilbestrol is administered to a woman during pregnancy, much of this material appears in the urine as a glucuronide. In the Venning method for the assay of urinary pregnanediol, all of the glucuronides are included in the final determination. Thus diethylstilbestrol glucuronide as well as pregnanediol glucuronide appears in the result obtained. The apparent rise in the urinary pregnanediol values obtained by the Venning method may be due to the ingested diethylstilbestrol which is conjugated and eliminated in the urine. The figures do not indicate an increased production of progesterone and resultant increased output of urinary pregnanediol.

Increasing amounts of diethylstilbestrol are being used in the treatment of pregnancy complications. In most instances the theory behind this therapeutic measure is that this estrogen stimulates steroid production. If urinary pregnanediol is to be used as a measure of increased steroid metabolism the value of diethylstilbestrol is open to question. It is possible that diethylstilbestrol exerts a favorable influence on placental circulation or on early placental development. However, there is no evidence that it results in an increased production of progesterone if urinary pregnanediol is to be regarded as an index of progesterone metabolism.