Biochemical assessment and prediction of gestational well-being

It is apparent from this brief review of serum markers that there is no ideal biochemical screen available to either assure fetal well-being or reliably predict fetal compromise. At present, MSAFP has become the dominant serum marker, but much work needs to be done to refine its usefulness as a screen and its utility in association with other measurements of fetoplacental well-being. The trend in modern obstetric management is toward an array of biophysical tests of fetal well-being, particularly in the last trimester of pregnancy. Biochemical screening in early gestation is used increasingly to assess future fetoplacental status and to predict risk for later pregnancy complications. Combinations of these biochemical and biophysical modalities will likely achieve the greatest predictive success in assessing fetal and placental well-being.