Maternal estrogen excretion before perinatal death

Abstract

As the value of urinary estrogen measurement in prevention of perinatal death has been questioned, a series of 626 consecutive perinatal deaths was studied to identify possible failures of the technique. 101 deaths related to singleton pregnancies during which urinary estrogen excretion had been measured; 32 deaths were preceded by normal estrogen excretion but no antepartum death from chronic placental failure occurred in this group, whereas 28 of the 69 deaths preceded by abnormal excretion were attributed to this cause. Most of these deaths were for various reasons regarded as unavoidable. There was one death possibly due to induction of labor done because of abnormal estrogen excretion. 4 deaths following abnormal results might have been avoided by appropriate action. 13 deaths might have been prevented if the assays had been performed in cases in which indications were present. It is concluded that urinary estrogen excretion is abnormal before fetal death from chronic placental failure. Other techniques to detect risk of fetal death have not undergone such extensive validation.