Abstract
A morphological examination of the fetal zone of the adrenal cortex has been carried out in 562 controls and 58 pathological cases, and maternal urinary oestriol excretion has been determined during the pregnancies, in order to elucidate the role of the fetal adrenals. The pathological cases consisted of infants of mothers with Rh-immunization, diabetes mellitus and toxaemia, together with a small group without any common features other than low oestriol excretion.
The adrenal weight was found to be correlated to the normal urinary oestriol excretion, and to a lesser degree to reduced excretion.
Both in Rh-immunization and diabetes mellitus the degree of necrosis in the fetal zone was increased, while the amount of haemorrhage did not differ from the controls. Moreover, in Rh-immunization an accumulation of lipid in the fetal zone was found. The morphological changes were related to the maternal oestriol excretion, and to the concentration of haemoglobin in infants of mothers with Rh-immunization, but not to the severity of the maternal diseases.
In toxaemia only cases with reduced maternal oestriol excretion differed from the controls, and both increased haemorrhage and necrosis were found, without any relation to the degree of toxaemia. In three toxaemic cases the width of the foetal zone was reduced. This was not found in any of the other groups. The rest showed massive necrosis of the foetal zone in three cases, lipid accumulation in one, and hypoplastic adrenals in one.
The importance of the morphological findings in the fetal adrenals of infants of mothers with Rh-immunization, diabetes mellitus and toxaemia is discussed.