Screening for Fetal Risk With Urinary Oestrogen: Creatinine Ratio at 34 Weeks

Abstract

Summary The urinary oestrogen :creatinine (O/C) ratio was measured in first morning specimens of 261 women at 34 weeks gestation to assess prospectively its potential in predicting fetal complications. Forty‐two patients (16.1 per cent) had low O/C ratios. All three stillbirths in the series occurred in this group and the incidences of fetal growth retardation and fetal distress in labour were also significantly increased. These complications were unusual when the O/C ratio was high. The O/C ratio at 34 weeks reflected fetal well‐being more accurately than clinical examination or blood pressure measurement. The mean O/C ratios of cigarette smokers and non‐smokers 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 weeks it appears to provide an early and fairly reliable indication of reduced placental function.

A comparison of saliva, plasma unconjugated and plasma total oestriol levels throughout normal pregnancy

“…Measurements of urinary oestrogen and of plasma unconjugated and total oestriol (E3) levels are widely used in the assessment of fetoplacental wellbeing. They have been shown to be mainly of value in the diagnosis of intrauterine growth retardation and in the management of the high risk and post-term fetus, particularly when the results are interpreted along with other indices of fetal wellbeing (Allen & Lachelin 1978;Goebelsmann 1979;O'Herlihy & Martin 1980;Khouzami et al 1981;Chard & Klopper 1982;London et al 1983).…”