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Blood Oestrogen Values during Labour when the Fetus is in Jeopardy
Author(s) -
Aickin D. R.,
Smith Margery A.,
Brown J. B.
Publication year - 1975
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.1975.tb00075.x
Subject(s) - medicine , percentile , fetus , fetal distress , pregnancy , obstetrics , population , venous blood , biology , statistics , genetics , mathematics , environmental health
Summary: A fluorimetric method has been applied to the measurement of total oestrogens in finger‐prick and peripheral blood collected during labour in 120 pregnancies (283 estimations). Signs of fetal jeopardy were present in 36 of these labours. The lower limits of normal for the second half of pregnancy were defined as the 10th percentile for a normal population of pregnant women. Near term this figure was 4.6 μg/100 ml blood. Serial blood oestrogen values obtained during the labours in which fetal jeopardy was not evident showed no consistent trends and the average coefficient of variation was 20%. Serial blood oestrogen values obtained during labours in which evidence of fetal jeopardy developed showed twice as many falling trends as rising trends and the average coefficient of variation was 27%. Seven pregnancies were identified in which the blood oestrogen values more than halved or more than doubled as labour progressed; 5 of these were associated with fetal jeopardy and one provided a unique example of blood oestrogen values which fell steadily over a period of 28 hours to less than a third of the commencing value during a labour in which acute fetal distress developed. Another showed the reverse effect of blood oestrogen values which steadily increased to 3 times the commencing level during a labour in which acute fetal distress developed. Twenty‐one per cent, of patients showed at least 1 low blood oestrogen value during labour compared with 26% before labour. The incidence of all features indicating fetal jeopardy was increased ( P = 0.01) when the blood oestrogen values were low during labour and all of the 4 stillbirths were associated with low values before fetal death. Blood oestrogen values during labour correlated with the plasma and/or urine values found before labour in the majority (79%) of pregnancies. It was concluded that the main application of blood oestrogen assays in labour is in the pregnancies where values have not been obtained recently before labour. However, markedly falling or rising oestrogen values were found during labour in a small number of pregnancies and the incidence of fetal jeopardy in these was high. Therefore, when suitably rapid oestrogen assay methods become available they might be of use in monitoring fetal welfare during labour, particularly when labour is prolonged.