Serum Unconjugated Estriol Levels Research Articles

Second-trimester maternal serum screening for fetal Down syndrome: As a screening test for hemoglobin Bart's disease: A prospective population-based study.

The purpose of this study is to determine the effectiveness of second-trimester maternal serum screening for Down syndrome as a screening test for fetal hemoglobin (Hb) Bart's disease among an unselected population. A secondary analysis of a large prospective database (20254 pregnancies) was conducted to compare the levels of maternal serum screening, alpha-fetoprotein (AFP), free beta-human chorionic gonadotropin, and unconjugated estriol between pregnancies with Hb Bart's disease and unaffected pregnancies. The median AFP levels were much higher among affected fetuses (1.96 vs 1.12 multiple of the median; P<.001), yielding a sensitivity of 81.6% and specificity of 86.4%. Thus, AFP measurement is effective in predicting fetal Hb Bart's disease among an unselected population when using a cutoff value of 1.5 multiple of the median. The serum free beta-human chorionic gonadotropin levels were slightly, but significantly, higher in the affected pregnancies, while the serum unconjugated estriol levels were minimally, but significantly, lower among the affected pregnancies. Second-trimester maternal serum AFP levels were significantly elevated in cases of fetal Hb Bart's disease. Pregnancies with unexplained elevated serum AFP levels in areas of high prevalence of Hb Bart's disease should always undergo a detailed ultrasound examination to detect any early signs of fetal anemia before development of hydrops fetalis.

The effect of maternal prednisone use on second-trimester maternal serum unconjugated estriol levels—Results from the FASTER trial

Prednisone is a widely used medication among women of childbearing age. Prednisone is known to alter the hypothalamic-pituitary axis, thus affecting endogenous maternal hormone levels. This study sought to determine the association between maternal prednisone use and changes in the unconjugated estriol values measured during second-trimester maternal serum screening.

Comparison between oral and intramuscular dexamethasone in suppressing unconjugated estriol levels during the third trimester

Objectives : Unconjugated estriol production depends on fetal adrenal androgen precursors. Fetal exposure to exogenous glucocorticoids results in adrenal suppression with a subsequent decrease in maternal serum unconjugated estriol levels. We compared the efficacy between oral and intramuscular dexamethasone in maternal serum unconjugated estriol suppression at 48 hours after the initial dose among women at risk for preterm delivery. Study Design: Twenty-four gravidas at risk for preterm delivery were randomized to receive either 6 mg intramuscular or 8 mg oral dexamethasone every 12 hours for a total of 4 doses. Blood samples (9 mL) were obtained before the initial dexamethasone administration and again after the fourth dose. Serum was separated and frozen at –70°C and subsequently underwent batch analysis. Unconjugated estriol levels were determined by radioimmunoassay with intra-assay and interassay coefficients of variation of 7.9% and 5.5%, respectively. All values are reported as mean ± SD. The primary statistical analysis was a t test, with P < .05 considered significant. Results: At the time of dexamethasone administration, gestational ages in both groups were similar. Predexamethasone and postdexamethasone unconjugated estriol levels were also similar between the intramuscular and oral groups (5.39 ± 3.99 vs 1.80 ± 2.49 ng/mL and 6.05 ± 3.00 vs 1.61 ± 1.03 ng/mL, respectively, P > .05). No difference in percent decrease in unconjugated estriol levels was found between the intramuscular (0.67 ± 0.24) and oral (0.65 ± 0.39) groups. Conclusion: Oral dexamethasone (8 mg) produces similar maternal serum unconjugated estriol suppression compared with intramuscular dexamethasone (6 mg) when evaluated 48 hours after administration.

Undetectable maternal serum unconjugated estriol levels in the second trimester: Risk of perinatal complications associated with placental sulfatase deficiency

OBJECTIVE: Our purpose was to determine the prevalence of undetectably low second-trimester maternal serum unconjugated estriol levels and the association with increased perinatal morbidity or mortality in pregnancies at risk for placental sulfatase deficiency. STUDY DESIGN: Nine centers in New England identified singleton pregnancies with undetectably low unconjugated estriol levels. Each unexplained case was matched with four controls; pregnancy outcome information was sought. RESULTS: Among 130,295 pregnancies surveyed, undetectably low unconjugated estriol levels were identified in 167 (13/10,000). Explanations included fetal death (53), overestimated gestational age (50), nonpregnancy (12), and chromosome abnormalities (5). The 41 unexplained cases were compared with 163 matched controls. Male offspring were more frequent (85%) among cases than among controls (55%). Although rates of perinatal complications were not significantly different, primary cesarean sections occurred about twice as often among cases. No perinatal deaths occurred. CONCLUSIONS: Neither severity of symptoms nor perinatal morbidity or mortality currently warrant routine interpretation of unexplained undetectably low unconjugated estriol levels as a marker for placental sulfatase deficiency.(Am J Obstet Gynecol 1997;176:531-5

Placental insufficiency as a possible cause of low maternal serum human chorionic gonadotropin and low maternal serum unconjugated estriol levels in triploidy

We report three cases in which triploidy (69,XXX) was detected by amniocentesis performed for very low maternal serum human chorionic gonadotropin levels. All three cases also had low maternal serum unconjugated estriol levels. We suggest placental insufficiency as the cause of the very low human chorionic gonadotropin because of histologic observations and because a known marker for placental insufficiency, estriol, was also very low.

Serum unconjugated estriol levels during spontaneous labor.

We measured maternal serum unconjugated estriol (SUE3) levels in 244 cases (218 cases with labor and 26 without labor) and investigated the relationships among several obstetrical factors and SUE3 levels. There was no significant difference in the SUE3 level between the group with labor and the group without labor. However, the SUE3 level decreased gradually with prolonged duration of labor in multipara. There were significant positive correlations between the SUE3 levels and birth weights (n = 82, r = 0.375, p less than 0.01) or placental weights (n = 82, r = 0.381, p less than 0.01) in the multipara with labor. The SUE3 levels of fetal distress cases (n = 30, 20.0 +/- 8.6 ng/ml) were significantly (p less than 0.05) lower than those without fetal distress (n = 188, 24.5 +/- 9.7 ng/ml). These data suggest that maternal SUE3 might have been affected with feto-placental function, even after the onset of labor SUE3 levels decrease with prolonged duration of labor.

Effect of phenobarbitone on serum unconjugated oestriol levels in pregnancy: A case report

Effect of phenobarbitone on serum unconjugated oestriol levels in pregnancy: A case report

Unconjugated serum oestriol levels in mother and baby with meconium staining of the amniotic fluid.

To examine the effect on oestrogen metabolism of the stimulus which causes the passage of meconium, we measured maternal venous and cord artery and vein serum unconjugated oestriol levels in 46 patients with meconium staining of the amniotic fluid and 19 controls. Mean cord vein oestriol levels were significantly lower than in controls in the presence of meconium stained amniotic fluid and no fetal acidosis (cord artery buffer base of 36.2 meq/l or more) (P less than 0.02). The same tendency was seen with acidotic infants (P less than 0.05). There is thus evidence of a change in oestrogen metabolism associated with meconium staining of the amniotic fluid.

Serum unconjugated estriol levels in the third trimester and their relationship to gestational age. II

The purpose of this study was to further validate a preliminary report concerning the clinical usefulness of serum unconjugated estriols as a marker of gestational age. Serial estriol values from 50 women with uncertain dates were plotted on semilogarithmic graphs and the gestational age predicted from the timing of the abrupt surge in estriol values which normally occurs between 35 and 36 weeks. the gestational age at birth, as determined by careful neonatal examination, agreed with the age predicted by the estriol surge within ±1 week.

Serum unconjugated estriol levels in the third trimester and their relationship to gestational age

Maternal unconjugated estriol levels were measured throughout the 28 to 41 week interval in two groups of accurately dated normal pregnancies. The first group consisted of randomly sampled pregnancies on which 285 unconjugated estriol determinations were performed. The logarithms of the mean values plotted into a positive sloping, relatively straight line which was disrupted by a plateau originating at 31 to 32 weeks and terminated at 35 weeks where there began a steep surge to a point at 36 weeks (surge point) that returned values to fit the previously established straight line. To investigate these findings in individual pregnancies, a second group of nine subjects was studied with serial unconjugated estriol determinations. In all nine of these subjects, the surge point could be identified statistically and occurred at a mean gestational age of 36.0 ± 0.6 (1 S.D.) weeks. Data from the first group of randomly sampled pregnancies indicate that the surge point occurred around a mean gestational age of 36.0 weeks and was confirmed by data from the second group of serially sampled individual subjects showing the surge point as a statistically definable marker in normal pregnancies.