Use of urinary estriol determinations in high-risk pregnancy in the community hospital

Abstract

Twenty-four-hour urinary estriol assays were done in 199 “high-risk” pregnancies. Records were reviewed to evaluate the validity and usefulness of the test in a community hospital. The correlation between estriol level obtained within 7 days of delivery and fetal survival was similar to that reported by others. Past 33 weeks of gestation, no fetal loss occurred if estriol was above 16 mg. per 24 hours, and no infants survived when estriol levels were less than 4.9 mg. per 24 hours. In 143 cases, estriol assays were helpful in clinical management. The most frequent use of the test was in allowing a pregnancy to progress to term. In 17 cases the decision to intervene was based on test results. Estriol determinations can be useful in the management of high-risk patients in a community hospital; however, it is susceptible to faulty use or misinterpretation.