Korrelationen zwischen dem Geburtsgewicht des Kindes, dem Placentagewicht und der m�tterlichen Oestriol-und Pregnandiolausscheidung bei Pr�eklampsie und bei chronischer Hypertonie

Cg, ässler

doi:10.1007/bf00669399

Cited by 3 publications

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“…This may be due to the wide ränge of values and may explain contradictory reports. The correlation was confirmed [l, 46,47, 76, 91 ], suspected [71,72] or rejected [21,51,52,65]. In underweight children low [14,16,31,72] or unchanged values [65] have been reported.…”

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confidence: 85%

Ultrasound and biochemical findings in intrauterine growth retardation

Kunz¹,

Keller²

1976

Journal of Perinatal Medicine

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The early recognition of fetal maldevelopment due to chronic placental insufficiency is of decisive importance if perinatal mortality and morbidity are to be further reduced. This can be achieved by direct and indirect methods, i.e. cephalometry and thoracometry using ultrasound on the one hand, and biochemical tests of the function of the fetoplacental unit, on the other. Estriol, pregnandiol and HPL levels and some placental enzymes are here of special interest. In this investigation an attempt was made to asses the diagnostic value of the various parameters and to suggest when they should be used. Jürg KUNZ, born 1942, Zürich, Studied medicine at University of Zürich, 1962-69 Curriculum vitae l Material and methodA total of 83 patients presently, or with a case history of risk hospitalised because of suspect placental insufficiency, was investigated. Twin pregnancies and those with doubtful duration were excluded. In the third trimester of pregnancy the following determinations were made: An average of 4 determinations of the biparietal head diameter using the B-scan method (Vidoson), 10 determinations of estriol and 3 of pregnandiol in urine [13,50] and 6 HPL determinations in the semm [49], 7 determinations of heat stable alkaline phosphatase (HSAP) [9], all per individual case. Biparietal head diameter values were transferred to a Standard curve that was in agreement with the one reported by HOLLÄNDER [42]. Growth retardation was assumed if the last two values showed the same trend with the date being certain and were below two Standard deviations or showed decreased progress. Biochemical parameters were considered to be pathological if they were below 95% of the normal values, with two values being outside this normal ränge or with 3 or more values being continuously below the 95% normal ränge. Maturity was assessed after birth from neurological and somatic signs of maturity according to D u BÖ-WITZ [25]. Infants were diagnosed äs small for date if their birth weight was below the lOth percentile on the LUBCHENKO curve [62]. ResultsFifteen of the 83 newborn were small for dates. Five had a gestational age of less than 37 weeks, 4 in the 35/36 week and one in the 30.5 week. A further 11 prematures was in the group of 68 normotrophic children. However, only 3 out of the 15 small for date infants were below the lower limit of the norm. The remaining 81 (98%) were within nonnal limits, 71 % below the curve for mean values. In twelve SGA infants the head diameter was normal prenatally and increased normally. Fig. 2 shows a very good correlation between weight percentile and the percentage deviation from the normal mean of estriol excretion. In all SGA cases values were found to be decreased. Ten were outside the 95% normal limits and 5 were still at least 40% below those limits. In infants with body weights between the lOth and 50 th percentile estriol values were below, the normal mean in 44%.Weight percentiles and HPL concentration in maternal serum ( Fig. 3) also correlated well. In 8 out of 15 SGA inf...

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