SCREENING FOR FETAL RISK WITH URINARY OESTROGEN: CREATININE RATIO AT 34 WEEKS

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Abstract
The urinary estrogen:creatine (O/C) ratio was measured in 1st morning specimens of 261 women at 34 wk gestation to assess prospectively its potential in predicting fetal complications. Patients (42; 16.1%) had low O/C ratios. All 3 stillbirths in the series occurred in this group and the incidences of fetal growth retardation and fetal distress in labor were also significantly increased. These complications were unusual when the O/C ratio was high. The O/C ratio at 34 wk reflected fetal well-being more accurately than clinical examination or blood pressure measurement. The mean O/C ratios of cigarette smokers and nonsmokers were similar, although smokers were delivered of lighter babies. Measurement of the urinary O/C ratio is simple and inexpensive. Used as a screening test at 34 wk it appears to provide an early and fairly reliable indication of reduced placental function.

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