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Comparison Between Plasma and Urinary Oestrogen Measurements in Predicting Fetal Risk
Author(s) -
Aickin D. R.,
Smith M. A.,
Brown J. B.
Publication year - 1974
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1974.tb00524.x
Subject(s) - urine , urinary system , fetus , pregnancy , medicine , endocrinology , amniotic fluid , obstetrics , physiology , biology , genetics
Summary: A fluorimetric method for measuring total oestrogens in late pregnancy plasma is described and data on its precision, sensitivity, accuracy and specificity is presented. One worker can complete 24 analyses in a day. A total of 311 parallel estimations of total oestrogens in plasma and urine were performed in 119 initially normal pregnancies to define the normal ranges. A further 454 parallel estimations were performed in 166 patients with pregnancy abnormalities likely to be associated with increased fetal risk. The incidences of low oestrogen values in the initially normal group of patients were 21% for plasma and 17% for urine; the corresponding incidences in the abnormal group were 42% for plasma and 28% for urine. The correlation coefficient between the plasma and urine values was 0.71 in the ‘normal’ group and 0.58 in the abnormal group. These correlations were highly significant but did not allow one value to be calculated from the other with any accuracy. Throughout the study, plasma and urine oestrogen assays did not give synonymous information and it was concluded that it would be dangerous to establish plasma oestrogen measurements as a test of fetal welfare merely on the basis that urine measurements were useful. Plasma oestrogen assays gave the same assessment of fetal risk in 226 pregnancies and opposite assessments in 59. In the 59 pregnancies, the plasma values were correct in predicting fetal risk as often as the urine values. In the total 285 pregnancies, all indices of fetal risk except the passage of meconium during labour were increased when the plasma or urine values were low and the levels of significance of these correlations were the same for plasma as for urine. There was no evidence that one assay was superior to the other in any pregnancy complication including renal disease, or that changes in plasma values gave a more immediate indication of a rapidly deteriorating fetal environment than urine. It was concluded that plasma and urine oestrogen assays give equally valid information in the assessment of fetal risk, that they could well be used as complementary tests and that because of ease of collection and avoidance of time delay, plasma assays could replace urine assays as soon as rapid fully automated assay methods are developed for plasma comparable to those now available for urine.