STRESS MEDIATORS IN THE AMNIOTIC COMPARTMENT IN RELATION TO THE DEGREE OF FETAL DISTRESS

In an attempt to locate biochemical markers specific for fetal distres s we measured the amniotic concentrations of beta-endorphin, ACTH, cor tisol, dopamine, norepinephrine and epinephrine with its major metabol ite metanephrine (MN) in pregnancies with documented fetal well-being and pregnancies complicated by hypertension and fetal distress. While higher levels of cortisol and MN were found only in a selected subgrou p of highly compromised subjects (p < 0.001 and p < 0.005, respectivel y), beta-endorphin increased significantly under conditions of moderat e or severe intrauterine sufferance (p < 0.001 in both cases). Due to higher levels of the opioid even during the initial stage of fetal dis comfort we evaluated its characteristics as a possible clinical marker . Specificity was 88.5%, whereas the sensitivity of 65.6% in the moder ately compromised subgroup increased to 88.9% in severely suffering fe tuses. Although more accurate and mainly real-time information on the fetal health status is obtained by means of biophysical methods, the d etermination of amniotic fluid beta-endorphin might be of clinical use fulness in prenatal diagnosis.