The Guterman Pregnancy Test

174

AXERICAX

JOURNAL

OF

OBSTETRICS

AND

GE’i%,ECOLOGU

References 1. Silbernagel, 2. Weinstein,

0. P.: W. M., and Burt, B. B., Mitchell, G. J., and

Ohio State M. J. 39: 1113, 1943. Sustendal, G. F.: AX J. OBST.

& GYNEC.

46:

283,

1943.

Reply by Dr. Hesseltine To

the E&or:

I appreciate the views of Dr. Silberndgel and Dr. Burt, and support their right to, clarify their views. I question not their results, but the mode of action which gave these results. We did not use the intravenous method as advised by Silbernagel and Burt, for we do not know of any pharmacological pro0.f that the intravenous route is distinctly superior to the intramuscular route. tion

Our primary concern of facts and adequate

was for proof, not contention. controls in all scientific studies.

We extend II.

CHICAGO

LYIKG-IN

the

Esditor

HESSELTINE,

for

compila-

M.D.

HOSPITAL

The Guterman To

CLOSE

the request

Pregnancy

Test

:

The May, 1946, issue of the AMERIC~ZN JOURNAL OF OBSTETKICS AND G~~;JXOI,OGY (Viol. 51, pp. 685-691) includes a paper by A. G. Morrow and R. 8. Benua entitled, “An Evaluation of the Guterman Pregnancy Test.” These authors set out to test the validity of the color met.hod of pregnanediol determination as a diagnostic test for pregnancy in a study of 19 patients. The original procedure was reported in two papers (J. Clin. Ew30crinaf. 4: 262-267, 1944; 5: 407-411, 1945), the conclusions being based upon an examination of 248 cases. The details of the method and its’basis are given in estenso there. This work has been completely confirmed in 304 cases by G. McCormack (AM. J. OBST. & GYNEC. 51: 722-725, 1946), who followed the technique closely. I should like here to point out the reasons which I think led to the contradictory results reported by Morrow and Benua in their small series. 1. The “slight modifications for convenience” are neither slight nor are they convenient include vacuum distillation over a steam bath for clinical laboratory use. These modifications instead of evaporation on the hot plate, the use of 1 ml. of a 10 per cent solution of sodium in 95 per cent ethanol instead of 20 ml. of a two per cent solution of sodium hydroxide in absolute methanol, and the use of No. 42 Whatman paper instead of fritted glass filters. 2. The authors adapted the qualitative color test to a Klett calorimeter employing a At, 500 mp pregnanertiol in concentrated suIfurie filter tra.nsmitting between 300 to 570 mp. The maximal color absorption is between 420 to 430 rni/ as acid shows little color absorption. reported by N. B. Talbot and co-workers (J. Clin. Endocrinol. 1: 668-673, 1941) and this laboratory (1944). That Morrow and Benua were not measuring pregnanediol alone is borne out by their inconsistent quantitative calorimeter readings upon the addition of pure In this laboratory, the addition of pure pregnanediol to male pregnanediol to male urine. urine leads to reproducible calorimeter readings (Klett-Summerson calorimeter, 420 rnp filter 430 rnp band) when the procedure is followed closely. and Cenco-Sheard spectrophotelometer, Since the method was not followed in important details, and since the calorimeter assay was done at a wave length which may include substances other than pregnanediol, the paper is strictly speaking not an evaluation of the test as published from this laboratory. HENRY DEPARTMENT AND

ENDOGRIXE

MICHAEL CHICAGO,

MAY

OF METABOLIC REESE ILL.

21, 1946

RESEARCH HOSPITAL

S. GUTERMAN,

M.D.