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Urinary estrogens in postterm pregnancy

V A Khouzami, J W Johnson, E Hernandez

    American Journal of Obstetrics and Gynecology
    |September 15, 1981
    PubMed
    Summary
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    Monitoring post-term pregnancies with 24-hour urinary estrogen per gram of creatinine (E/Cr) is crucial. Low E/Cr levels significantly increase perinatal mortality and fetal distress risks in post-term pregnancies.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Reproductive Endocrinology

    Background:

    • Post-term pregnancy poses risks to fetal well-being.
    • Effective monitoring strategies for post-term pregnancies are essential.
    • Urinary estrogen to creatinine ratio (E/Cr) has been proposed as a monitoring tool.

    Purpose of the Study:

    • To evaluate the utility of 24-hour urinary estrogen per gram of creatinine (E/Cr) in identifying high-risk post-term pregnancies.
    • To assess the correlation between E/Cr levels and adverse perinatal outcomes.

    Main Methods:

    • Retrospective review of 677 post-term pregnancies over 40 months.
    • Established the tenth percentile (18 mg/gm) as the cutoff for low E/Cr.
    • Compared corrected perinatal mortality rates (PMR) and fetal distress incidence based on E/Cr levels.

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    Main Results:

    • Low E/Cr in post-term pregnancies was associated with a 40-fold increase in corrected PMR (9.2% vs. 0.23%).
    • Incidence of fetal distress was significantly higher in post-term pregnancies with low E/Cr (57% vs. 5.5%).
    • Three of four stillborn infants had recent fetal well-being tests, highlighting limitations of standard testing.

    Conclusions:

    • 24-hour urinary E/Cr is a reliable indicator for identifying high-risk post-term pregnancies.
    • Low E/Cr levels suggest a need for increased obstetric surveillance and potential intervention.
    • The E/Cr test can aid in managing post-term pregnancies and improving perinatal outcomes.