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Hormonal analyses have become indispensable for managing high-risk pregnancies. They allow an early diagnosis of chronic disturbances in the nutritive function of the placenta and of fetal growth retardation. However, except for a few clinics [2, 9] hormonal assays are frequently used only when the placental dysfunction is already clinically manifest (premature labor, discrepancy between uterine size and estimated gestational age, etc.) or if there are serious risk factors from the history. Not infrequently "placental insufficiency" is not accompanied by any clinical Symptoms [10, 18] and thus escapes diagnosis, or at least early diagnosis. Early diagnosis, however, is the decisive prerequisite for successful therapy which must have its goal a mature healthy newbom with a normal birth weight. Biochemical parameters in contrast to clinical and biophysical obstetric indicators are currently the only ones which give any direct Information about the function of the placenta. Measurements of placental perfusion with radioisotopes cannot be used in clinical routine äs yet. Therefore, hormonal assays should indicate disturbances in placental function earlier than the other variables. Thus, the medically correct procedure would consist of

journal of perinatal medicine

Prognostic value of combined assay of total estrogen and pregnanediol in 24 hour urine. Experience with 500 pregnancies in an endocrine surveillance program during the second trimester