The end product of progesterone metabolism, pregnandiol, is determined as sodium pregnandiol glucuronidate by a gravimetric method developed by Venning and Browne.1Estimations of this complex have been made by various investigators in normal and pathologic menstrual periods, in normal pregnancy, abortions, toxemias and, lastly, in cases of the adrenogenital syndrome.2 Except in an isolated case (a child aged 3 years), there have been no data available among children.3The accumulated literature to date has already been well summarized, but it may be well to recall a few pertinent facts regarding the excretion of pregnandiol. This compound is excreted in the urine during the luteal phase of the normal menstrual cycle when the corpus luteum is active and absent during the first half of the intermenstrual phase. The amount of pregnandiol determined for the whole cycle may vary from 34 to 54 mg., although the daily output may be 2 to 10 mg.4During pregnancy the compound is excreted in increasing quantities in the urine as gestation proceeds, when its production is attributed to the placenta. The mean figure as given by Venning 5 is 75 mg. a day and by Cope 6 as 55 mg. daily, with wide variations. The presence of pregnandiol in association with amenorrhea is suggestive of pregnancy and is to some extent used as a diagnostic aid.7 The absence or diminution of pregnandiol during pregnancy is indicative of a patho¬ logic condition such as threatened abortion or death of the fetus.8 There is some difference of opinion as to the metabolism of pregnandiol in toxemias of pregnancy and the role of the kidney in its excretion.9 The metab¬ olism of progesterone in the body has been adequately described by Hamblen,10 Venning,11 and Cope6 and includes ovarian, hepatic, uterine and renal factors. Our interest was stimulated by 2 cases of pseudohermaphroditism which we had occasion to study and in which pregnandiol titers were determined. We specu¬ lated as to the diagnostic value of pregnandiol in these cases, and, because of the paucity of data in the young age group, determinations on other children were made for comparison. These include a pubescent boy and girl, 2 girls with prolonged menstrual bleeding, a pre¬ cocious pubescent child and a Lorain-Levi dwarf.12These are not included in this report.The need for total and complete urine specimens was stressed by several groups, but recently Bachman 8 suggested that only a portion of the urine is necessary for analysis. He felt that the general trend of values gives enough information in cer¬ tain conditions, especially in the last months of preg¬ nancy.We expected the amount of pregnandiol in the urines of children to bvery small ; therefore, in order that a sufficient yield of .he com¬ pound could be obtained large pooled volumes of urine were extracted. In most instances the urines were pooled into forty-eight hour lots and the total vol¬ ume was extracted. Some¬ times with this procedure the final weighed precipitate was of no significance.
