In order to study the function of the pituitary-adrenal axis, serum
ACTH and
cortisol levels were estimated before and after
insulin induced hypoglycaemia in nine women with
hyperemesis gravidarum, seven women in normal early pregnancy and in eight non-pregnant controls. Before hypoglycaemia, the basal
ACTH level in the hyperemesis group (102-4+/-62-9 pg/ml) was higher than in normal early pregnancy (67-5+/-19-2 pg/ml; p less than 0-05) or in non-pregnant controls (54-8+/-25-2 pg/ml; less than 0-01). Correspondingly, the mean
cortisol value in hyperemesis (0-47+/-0-16 mumol/l) was higher than in normal early pregnancy (0-39+/-0-10 mumol/l; p greater than 0-05) or in non-pregnant controls (0-32+/-0-13 mumol/l; p less than 0-01). After
insulin the elevation of
ACTH (p greater than 0-05) and
cortisol (p less than 0-01) was observed in every group. The level of
ACTH and
cortisol was highest in hyperemesis group. Our results do not support the idea that hypofunction of the pituitary-adrenal axis contributes to the aetiology or pathogenesis of
hyperemesis gravidarum. The high
ACTH level might be evidence of the psychia instability of
hyperemesis gravidarum patients.