A simple DHEAS loading test in the antepartum diagnosis of placental sulphatase deficiency

The accurate antenatal diagnosis of placental sulphatase deficiency (PSD) is essential if this condition is to be distinguished from others in which levels of oestrogen are low. In this study we have evaluated a simple protocol determining the serum oestradiol response to 50 mg of dehydroepiandrosterone sulphate (DHEAS) given intravenously to twelve women with low serum or urinary oestrogens. Seven of the women had PSD confirmed by other means, the remaining five had other reasons for the low oestrogen levels. In affected pregnancies the rise in oestradiol was lower, the peak occurred earlier and the level fell towards baseline at 60 min. In the unaffected women, timing of the peak value was not consistent and there was no trend towards basal values at 60 min. There was clear discrimination between the two groups at all times after the injection, but the separation was greater at 60 min.