During normal human pregnancy alterations in liver function similar to those seen in cholestasis occur (Tindall & Beazley, 1965; Haemmerli & Wyss, 1967). Adlercreutz & Tenhunen (1970) concluded that oestrogens were primarily responsible for this effect. In a previous report from this laboratory (Tikkanen, 1972) progressive changes, including decreasing proportions of OE3-3Gl† and increasing proportions of OE3-3S,16Gl†, in the urinary excretion of oestriol conjugates during pregnancy were noted, which were regarded as reflections of changes in the excretory function of the liver. Since a clear consistent change in urinary oestriol conjugate pattern was not observed in all the pregnancies studied, it appears that some women are more susceptible than others to this action of oestrogens on liver function. In multiple pregnancies Beazley & Tindall (1966) noted changes in the excretory function of the liver that were similar to but greater than those previously observed in singleton pregnancies. Accordingly, it might
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