A Scoring System for the Assessment of Multiple Methods of Monitoring Fetal Growth

Robinson, Hugh P.; Chatfield, W. R.; Logan, R. W.; Tweedie, A. K.; Barnard, William P.

doi:10.1111/j.1471-0528.1973.tb02190.x

Cited by 15 publications

(9 citation statements)

References 27 publications

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“…Several authors have found an association between birth-weight and matemal serum levels of hCS, estriol and oxytocinase [l, 8,10,11,12,14,15,16,17,18,20,21,22,23,25,28]. However, this association was not confirmed by others [4,6,7,19,27].…”

Section: Discussionmentioning

confidence: 44%

Human chorionic somatomammotropin, estriol and oxytocinase as indexes of fetal growth

Giussi¹,

Vinacur²,

Ballejo³

et al. 1979

Journal of Perinatal Medicine

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Section: Discussionmentioning

confidence: 44%

Human chorionic somatomammotropin, estriol and oxytocinase as indexes of fetal growth

Giussi¹,

Vinacur²,

Ballejo³

et al. 1979

Journal of Perinatal Medicine

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“…One hundred and eleven results from the 34 normal pregnancies were used to construct a normal range between 30 and 40 weeks of gestation. In common with other workers, we found that the normal values followed a lognormal distribution and transformation was effected as previously described (Robinson et al, 1973) before depicting the median values and 95 % confidence limits. …”

mentioning

confidence: 98%

“…The results were assessed by a scoring system, and it was found that a combination of sonar cephalometry and 24 h urinary oestriol assays gave the most reliable prediction of intrauterine growth retardation.In a previous communication, Robinson et al (1973) compared the value of five methods of fetal monitoring in respect of their ability to differentiate between normal and growth-retarded pregnancies in a small series of patients. These tests included sonar biparietal cephalometry, 24 h urinary oestriol assays and determination of serum oxytocinase, total alkaline phosphatase and heat-stable alkaline phosphatase activities.…”

mentioning

confidence: 99%

“…11 was possible, however, to include all 11 cases involving intrauterine growth retardation. An average of 4.3 weekly estimations were performed on each patient.The methods employed in measuring the biparietal diameters and urinary oestriol levels, the scoring system as applied to these parameters, and the 15 diagnosis of intrauterine growth retardation have already been described (Robinson et al, 1973). …”

mentioning

confidence: 99%

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Intrauterine Fetal Growth Retardation: A Comparison of Human Placental Lactogen Urinary Oestriol and Biparietal Diameter Measurements

et al. 1974

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Forty-two 'at risk' pregnancies were serially monitored by sonar biparietal cephalometry, 24 h urinary oestriol assays and determination of serum human placental lactogen. The results were assessed by a scoring system, and it was found that a combination of sonar cephalometry and 24 h urinary oestriol assays gave the most reliable prediction of intrauterine growth retardation.In a previous communication, Robinson et al. (1973) compared the value of five methods of fetal monitoring in respect of their ability to differentiate between normal and growth-retarded pregnancies in a small series of patients. These tests included sonar biparietal cephalometry, 24 h urinary oestriol assays and determination of serum oxytocinase, total alkaline phosphatase and heat-stable alkaline phosphatase activities. In order to evaluate the results, a preliminary scoring system was devised where points were allotted to the overall level and to the trend of the results. Using this system it was found that a combination of sonar cephalometry and urinary oestriol assays gave the most reliable prediction of intrauterine fetal growth retardation. No individual test satisfactorily separated the normal from the abnormal pregnancies and, in particular, the enzyme tests were found to be of little clinical value.During the course of the investigation, reports appeared stressing the apparent value of human placental lactogen (HPL) as a test of placental function (Keller et al., 1971;(Letchworth and Chard, 1972). It was, therefore, decided to measure the HPL concentration in the sera already collected and to apply to the results a scoring system similar to that previously described, and thereby to compare the resulting scores with those obtained using biparietal cephalometry and urinary oestriol assays. MATERIAL AND METHODOf the 45 patients in the original series, insufficient HPL results were available from three of the 34 normal pregnancies to allow their inclusion in the scoring system, although the individual values in the three cases were used when compiling the HPL range in normal pregnancies. 11 was possible, however, to include all 11 cases involving intrauterine growth retardation. An average of 4.3 weekly estimations were performed on each patient.The methods employed in measuring the biparietal diameters and urinary oestriol levels, the scoring system as applied to these parameters, and the 15 diagnosis of intrauterine growth retardation have already been described (Robinson et al., 1973). HPL methodThe sera were stored at -20°C prior to determination of the HPL concentration by the commercially available Phadebas HCS Test kit. Analyses were performed in duplicate and the means of the paired results were used when constructing the normal range and in the assessment of all values. Determined in this fashion, the coefficient of variation for an individual result averaged 6 %. One hundred and eleven results from the 34 normal pregnancies were used to construct a normal range between 30 and 40 weeks of gestation. In common with other work...

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“…Some workers [17] consider an endocrine parameter to be not only normal or pathological but assign it a certain weight for estimating the risk, by evaluating its transverse position according to a point System, (e. g. estrogen excretion = low normal = l point, in dubious pathological r nge 2 points etc.). This leads to the following question: Is there a critical lower limit for estrogen excretion below which it is better to terminate pregnancy, i. e. for which chances for survival are better outside the uterus than within.…”

Section: Other Problems A) Critical Limit Of Hormone Excretionmentioning

confidence: 99%

An endocrine model for the diagnosis of intrauterine growth retardation as demonstrated by the determination of total estrogen and pregnandiol 24-hour urinary excretion in 222 at risk pregnancies

Wolfrum¹,

Bordasch²,

Holweg³

1975

Journal of Perinatal Medicine

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Today urinary excretion of estrogen äs an indicator of possible pregnancies at risk is an accepted parameter. For a long time excretion of estrogen was considered äs a so-called fetoplacental indicator; since both fetus and placenta participate in estriol synthesis. However, recent findings indicate [7,22,23] that the fetus is, to some extent, independent of the placenta äs far äs the synthesis of estriol precursors is concerned. It has also been demonstrated that the capacity of the placenta to form aromatic compounds is not decreased but rather elevated in severely impaired nutrition [21]. Heüce decreased estrogen excretion is more probably due to limited synthesis in the fetus than in the placenta. The lack of placental sulfatase is an exception that is hardly of quantitative importance [6,8]. Hence the rate of estrogen excretion may be considered a fetal rather than a fetoplacental parameter. Usually an impairment of the nutritive function of the placenta that is chronic in nature is the basis of the endocrinologically assayable danger to the fetus. If urinary estrogen excretion is decreased it must be assumed that the fetus has already been damaged. Hence for perinatal diagnostic purposes it is desirable to use a purely placental indicator that might indicate danger earlier than estrogen excretion and that permits us to distinguish between fetal and placental malfunction. Three hormone tests are usually applied: HPL (human placental lactogen) in serum; pregnandiol in urine äs an indicator of progesteron metabolism and plasma progesteron. HPL indicates the rate of proteinsynthesis in the placenta and pregnandiol its steroid biosynthesis. The introduction of radioimmunological tests for HPL has feduced pregnandiol determinations with their well known drawbacks related to urinary analyses. Pregnandiol determinations very often gave false normal J. Perinat. Med. 3 (1975) Curriculum vitae

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A Scoring System for the Assessment of Multiple Methods of Monitoring Fetal Growth

Cited by 15 publications

References 27 publications

Human chorionic somatomammotropin, estriol and oxytocinase as indexes of fetal growth

Human chorionic somatomammotropin, estriol and oxytocinase as indexes of fetal growth

Intrauterine Fetal Growth Retardation: A Comparison of Human Placental Lactogen Urinary Oestriol and Biparietal Diameter Measurements

An endocrine model for the diagnosis of intrauterine growth retardation as demonstrated by the determination of total estrogen and pregnandiol 24-hour urinary excretion in 222 at risk pregnancies

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