Study of fetal reserve in intrauterine fetal growth retardation (author's transl)

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caused by small fetus resulting from small maternal body of reasons unknown mostly have satisfactory courses after birth. On the other hand, fetal malnutrition often causes fetal distress and the post-natal prognosis is sometimes unfavorable.Therefore, in the case of IUGR, it is necessary to judge correctly whether the fetus is in a state of well being or latent fetal distress.In this study, fetal reserve is examined by means of fetal function testing constituted of fetal response to tone stimulation and by fetal placental function tests including the quantitative determination of urinary estriol, serum Cystine aminopeptidase (CAP), Leucine aminopeptidase (LAP), Heat-stable alkaline phosphatase (HSAP) activities in subjects whose newborns are light for dates after birth.1) Two hundred and seventy subjects light for dates after birth could be classified as follows: Fetal malnutrition, 181cases (67.04%); fetal hypoplasia, 15 cases (5.56%); uncertain, 68 cases (25.19%); maternal predisposition, 6 cases (2.22%).2) Fetal response to tone stimulation, maternal urinary estriol, maternal serum CAP, LAP, and HSAP levels were all lower in the subjects than in controls where the course of pregnancy was normal.3) In the IUGR group, many subjects with fetal malnutrition showed lower values in fetal response to tone stimulation, maternal urinary estriol maternal serum CAP, LAP, and HSAP activities in comparison with others.4) Fetal response to tone stimulation may not adequately indicate fetal reserve, since the result is sometimes negative even in a normal course of pregnancy during pre-term (less than 37 weeks). However, when the result is positive, this test is very reliable for demonstrating satisfactory fetal reserve.5) The results of the examinations including fetal response to tone stimulation, maternal urinary estriol, and maternal serum CAP, LAP, and HSAP activities showed lower valves in subjects with toxemia of pregnancy, especially in severe cases, and this tendency was more remarkable in the subjects whose newborns were light for dates after birth.If IUGR of high-risk pregnancy is clinically suspected, the appropriate consideration of the high frequency of unfavourable prognosis or clinical course, the fetal respons to tone stimulation, maternal urinary estriol, maternal serum CAP, LAP, and HSAP activities test are necessary in view point of evaluating the fetal reserve capacity.