|
KMID : 0377619720230060607
|
|
Korean Jungang Medical Journal
1972 Volume.23 No. 6 p.607 ~ p.619
|
|
|
Evaluation of Urinary Estriol in Normal and Abnormal Pregnancies
|
|
|
|
|
Abstract
|
|
|
Urinary estriol estimation is very helpful for fetal program during pregnancy although it has not been widely used in obstetrics.
In this paper the fluctuations of maternal estriol both, in normal and abnormal pregnancies, hypertensive or toxemic state, intra-uterine fetal death or similar conditions, and of post-dated pregnancy were studied.
The data presented here are based on 52 pregnant patients examined in Ewha Woman´s university Hospital, Seoul, Korea.
Twenty-four hour urine was collected and analyzed by the Brown method.
At the same time the vaginal smear was taken from mid-lateral portion of vaginal wall and stained by papanicolaou technique.
The obtained results are as follows:
1. Urinary estriol in normal pregnancy gradually increases in the 20th week of -gestation up to term, and the mean estriol level during the period of 36th week to term was 15.6mg/24 hours. No less than 4mg/24 hours was observed in or after 26th week of gestation in normal conditions.
2. Generally, in toxemia or hypertensive complication of pregnancy, the estriol excretion decreases significantly (P<0. 05) with the mean value of 8. llmg/24 hours ±S.E. 0. 91 in the 37th week up to term. There appears tendency of chronic placental insufficiency or fetal distress in toxemia of pregnancy on the basis of the decreased fetal weight as well as poor Apgar scores.
3. In general, the higher the systolic blood pressure the greater decrease of the urinary estriol level. There was no significant difference between mild and severe toxemias in the urinary estriol level. It is interesting to note that once the systolic blood pressure is elevated up to 150mmHg, the estriol excretion decreases to the same level as that at a much higher level of systolic pressure, such as 160-200mmHg.
4. The levels of maternal urinary estriol in preeclampsia and eclampsia were not significantly different. No fetal loss was encountered even in preeclampsia with a markedly decreased estriol level. On the other hand, it was noted that a greater. number of fetal loss was encountered in eclampsia with relatively higher estriol.
5. Vaginal cytologic smear test is a good method for the evaluation of the urinary estriol level and it is an adjunct of the fetoplacental function test.
6. In the last month of pregnancy, although there was no recognizable correlation in between the fetal weight and the urinary estriol level in toxemia of pregnancy as the fetal weight increases.
7. In toxemia of pregnancy, there was no correlation between the urinary estriol and the uric acid level.
8. Urinary estriol excretion in the intra-uterine fetal death without hypertensive complication of pregnancy showed significantly lower level, less than 2.Omg/24 hours. On the contrary, the estriol level in the intra-uterine fetal death in convulsive or eclampsic woman did not decrease to such a remarkable degree as in the intrauterine fetal death in non-toxic state, suggesting a restriction in the fetoplacental evaluation.
Vaginal cytology in the intra-uterine fetal death gives an information of the level of urinary estriol, and shows a placental insufficiency picture.
9. The so called "post-dated pregnancy" merely based on the menstrual age did not invariably show a true over maturity, hormonally or cytologically.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|