Diagnosis of Intrauterine Fetal Growth Retardation by Serial Serum Oxytocinase, Urinary Oestrogen and Serum Heat Stable Alkaline Phosphatase (Hsap) Estimations in Uncomplicated and Hypertensive Pregnancies

Abstract

Summary Serial estimations of serum oxytocinase, urinary oestrogen and serum heat stable alkaline phosphatase (HSAP) were performed during pregnancy in normotensive and hypertensive patients. Patients delivered of growth retarded infants whether hypertensive or not, failed to show the progressive increase in serum oxytocinase. urinary oestrogen and serum HSAP seen in the group of patients delivered of normal infants. By using the regression coefficient (x1) of log10 enzyme or hormone concentration on time of gestation and the mean value (x1) for each patient, linear discriminant functions of the form Z = a1 x1+a2x2+C were derived and satisfactory prediction of intrauterine fetal growth retardation was achieved over two time intervals, namely 28 to 35.5 weeks and 34 to 40 weeks gestation. Serum oxytocinase was found to be superior to urinary oestrogen assays for the prediction of intrauterine fetal growth retardation. Serum HSAP estimations carried out on a smaller number of patients were less useful for this purpose. By combining the urinary oestrogen and serum oxytocinase results into a single discriminant function, normal fetal growth was predicted in 33 out of 37 patients and intrauterine fetal growth retardation in 21 out of 22 patients studied between 34 to 40 weeks gestation.

Association of Fetal Growth with Maternal Nutrition

“…Cystine aminopeptidase (oxytocinase) also is synthesized by the placenta. Measurements in matemal serum of HPL (Hobbins, 1975), oxytocinase (Pathak et al, 1974), and oxytocinase combined with urinary estrogen excretion (Petrucco et al, 1973) have been correlated with poor fetal growth.…”

Comparison of Substrates for Measuring Cystyl-Amino Peptidase. Activity in Serum of Pregnancy and Hepatic Disease and in Various Tissues

“…It has suggested that plasma oestriol values would be more useful for determining feto-placental viability than the corresponding urinary measurement (69-71). Although previous studies have shown correlation between the urinary oestrogen levels and the serum cystyl-amino peptidase activity (21,22,28,29,(72)(73)(74), it is not well understood with respect to the relationship between the serum cystyl-amino peptidase activity and the plasma oestriol level. In this study, therefore, the plasma oestriol level and the cystyl-amino peptidase activity with various substrates were studied simultaneously in pregnancy.…”

“…Serial serum cystyl-amino peptidase estimations appear to be helpful in the diagnosis of placental failure (17)(18)(19)(20) and the management of intrauterine fetal growth retardation and fetal distress, etc (21)(22)(23)(24)(25)(26)(27), but there is some controversy (28)(29)(30)(31)(32). This may be the consequence of differences in various methods used for the enzymes assay.…”

CAP, HCS and urinary estriol measurements in risk pregnancies – A comparative study

“…CURZEN and VARMA [7] who compared CAP and urinary estriol assays concluded that CAP was of no value in predicting the condition of the feto-placental unit. Other authors [3,4,9,17,19,22] Comparative studies using all three parameters are scanty. KRISTENSEN et al [5] compared HCS, CAP and urinary estriol excretion in pregnancies complicated with essential hypertension and preeclampsia.…”