Comparison between Urinary Oestrogen Assay and Serial Ultrasonic Cephalometry in Assessment of Fetal Growth Retardation

Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants

“…Seven of the studies were in high-risk cohorts and two were in mixed-risk cohorts. Five studies (Campbell 1972;Kunz 1976;Oats 1979;Steiner 1991; Weerasinghe 1977) did not state whether or not index test results led to interventions, three studies (Chew 1976;Fliegner 1979;Odendaal 1981) did not intervene based on index test results and one study (Beischer 1991) stated that oestriol levels were an indicator for early delivery, although no numbers were given. Studies used different index test positivity thresholds ( Figure 5) but four studies (Beischer 1991;Fliegner 1979;Oats 1979;Steiner 1991) used a threshold of 8 mg per 24 hours (at 30 weeks) to 12 mg per 24 hours (at 40 weeks).…”

“…Five studies were in high-risk cohorts and two were in mixed-risk cohorts. Three studies (Campbell 1972;Oats 1979;Weerasinghe 1977) did not report whether there were any interventions based on index test results, two studies (Chew 1976; Fliegner 1979) did not intervene due to index test results while in two studies (Beischer 1991;Elliott 1970) index test results affected pregnancy management; in the Elliott study there were five cae-sarean sections that were performed due to greatly reduced oestriol excretion. The studies used different thresholds with sensitivities ranging from 0 to 1, and specificities from 0.60 to 1.00.…”

Ultrasonic recognition of two types of growth retardation by measurement of four fetal dimensions

“…Thus it is important to recognise these babies and the earlier in fetal life the better. Increased sophistication of clinical and laboratory methods has enabled better antenatal detection and it is now widely accepted that serial ultrasonic biometry is the most accurate method for physically measuring fetal growth [4,10,11,12,15,23]. In a recentpaper,Rosso and WINICK [25] supported the hypothesis that there are different types of infants with intrauterine growth retardation and that these different types can and should be recognised.…”

“…The attention of both the \obstetrician and pediatrician has focused on this problem because these babies have a high incidence of perinatal death and intrapartum asphyxia, and are at increased risk in the neonatal period from pulmonary hemorrhage, hypoglycaemia and fetal abnormality [3,4,13]. In the long term there is evidence that severely growth retarded babies suffer from intellectual impairment, especially if neonatal management is less than adequate [1].…”

The Use of Placental Function Tests in a London Teaching Hospital

“…This finding implies that the past obstetric history did not greatly influence selection of patients for placental function tests, although those with a history of preterm delivery may also have had complictions which constituted a more rational indication for placental function tests. Campbell and Kurjack (1972)"/12 pointed out that only 30% foetuses with IUGR were detected as such antenatally by c1incial methods. It might, therefore, be more appropriate, and less expensive, to carry out a single biochemical screening tests on all women (say a serum HPL) and to monitor more intensively those with abnormally low results rather than allowing clinical impression alone to determine how the availabe investigations are used.…”