FIGURE 7 Biosynthesis of estrogens during pregnancy. Note that androgens formed in either the fetal or maternal adrenals are the precursors for all three estrogens and that the placenta cannot convert progesterone to androgens. Hydroxylation of dehydroepiandrosterone sulfate on carbon 16 by the fetal liver gives rise to estriol, which is derived almost exclusively from fetal sources. Fetal androgens are secreted as sulfate esters and must first be converted to free androgens by the abundant placental sulfatase before conversion to estrogens by the enzyme P450aromatase (P450arom). 3^HSD, 3^-hydroxysteroid dehydrogenase.
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