TOXEMIA OF PREGNANCY - ASSESSMENT OF FETAL DISTRESS BY URINARY ESTRIOL AND CIRCULATING HUMAN PLACENTAL LACTOGEN AND ALPHA-FETOPROTEIN LEVELS

The efficacy of 3 biochemical methods for the detection of fetal distress was assessed in a prospective study of 224 singleton pregnancies complicated to toxemia. Fetal distress was diagnosed in 65 cases (29%). Abnormally low urinary estriol (E3) excretion pointed out 63%, low serum levels of human placental lactogen (HPL) 27%, and elevated maternal serum .alpha.-fetoprotein (AFP) 10% of distressed fetuses. The efficacy of each test increased with the severity of maternal disease. The frequencies of false pathologic levels were: E3, 19%; HPL, 0%; and AFP, 1% of the cases with a normal fetal outcome. Although E3 was by far the most effective marker, abnormal levels of HPL and AFP provided supportive evidence for fetal distress by pointing out those cases in which E3 reading was not a false positive.