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Institute of Obstetrics and Gynaecology, Queen Charlotte's Hospital, Goldhawk Road, London, W6 OXG

(Received 4 September 1974)

It is well established that the rise in total plasma cortisol which follows the administration of corticotrophin (ACTH) or tetracosactrin is greater in late pregnancy than in non-pregnant women (Jailer, Christy, Longson, Wallace & Gordon, 1959; Campbell, Bain, Dewhurst & Fotherby, 1970; Johnstone & Campbell, 1974). However, it is not clear whether this can be completely explained by the increased corticosteroidbinding globulin levels in pregnancy (Doe, Fernandez & Seal, 1964; De Moor, Steeno, Brosens & Hendrikx, 1966) or whether there is a true rise in tissue exposure to unbound cortisol. In non-pregnant subjects, 1·0 mg depot tetracosactrin (Ciba) appears to give a maximal adrenal stimulus, at least over the first 4 h (Besser, Butler & Plumpton, 1967; Nelson, Neill, Montgomery, Mackay, Sheridan & Weaver, 1968), and we have described the total 11-hydroxycorticosteroid patterns