Comparison of urinary estrogens, contraction stress tests and nonstress tests in the management of postterm pregnancy.
In a retrospective review of 697 postterm pregnancies we attempted to validate three tests used to identify the fetus at increased risk: the 24-hour urinary estrogen per gram creatinine (E/Cr), the nonstress test (NST) and the contraction stress test (CST). Using the corrected perinatal mortality rate (PMR) among term pregnancies (0.23%) as a standard for comparison, we found the PMRs among postterm patients with negative screening tests to be as follows: 0.23% with normal E/Crs, 0.65% with negative CSTs (not significantly different) and 2.4% with reactive NSTs (p less than 0.005). When we used intrapartum fetal distress as a standard for comparison, the E/Cr exhibited the highest sensitivity (88%) whereas those of the CST and NST were much lower (7-10%). The specificities were 63%, 98% and 92%, respectively. From this retrospective study the E/Cr appears to be of most assistance in identifying fetuses at increased risk, the CST is of intermediate assistance, and the NST is of least assistance.
D004967:Estrogens / Q000652:urine*; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005318:Fetal Heart / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D007226:Infant Mortality; D011247:Pregnancy; D011273:Pregnancy, Prolonged; D014590:Uterine Contraction
D004967:Estrogens