Hormonal placental function tests for fetal assessment in high risk pregnancies.
BACKGROUND
Biochemical tests of fetal well-being such as placental hormone levels have not always shown direct benefits for mothers and babies.


OBJECTIVE
The objective of this review was to assess the effects of measuring placental hormone levels during high risk pregnancies.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register and MEDLINE. We also contacted study authors.


METHODS
Adequately controlled trials comparing availability with no availability of hormone placental tests in high risk pregnancy.


METHODS
Trial quality was assessed and data were extracted by two reviewers and this was checked by a colleague. Study authors were contacted for additional information.


RESULTS
Two trials involving 3355 women were included. Methodological quality of the trials was acceptable, but results for only 230 out of 2733 women (abnormal hormone levels) were available from one trial. One trial compared oestriol levels reported promptly with levels measured but not reported. The overall perinatal mortality rate was 30.5 per 1000 live births weighing 500 grams or more. No beneficial effects of oestriol measurement on fetal outcome could be identified (odds ratio of perinatal death 0.87, 95% confidence interval 0.35 to 2.18). For abnormal test results only, the reported oestriol group showed a statistically non-significant trend to less perinatal mortality (odds ratio 0.48, 95% confidence interval 0.15 to 1.60). The other trial compared human placental lactogen measurements reported promptly with measurements not reported until after pregnancy. For abnormal test results, the reported group showed significantly less perinatal mortality with four (3.4%) deaths compared to 17 (15%) in the control group (odds ratio 0.25, 95% confidence interval 0.10 to 0.61). Data from normal test results was not available for this trial.


CONCLUSIONS
The measurement of human placental lactogen levels may be of some value in high risk pregnancies, but there is not enough evidence to evaluate the use of hormone placental tests generally.
Neilson
J P
JP
Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool, UK, L69 3BX. jneilson@liverpool.ac.uk
Cloherty
L J
LJ
D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D010925:Placental Function Tests; D010926:Placental Hormones; D011247:Pregnancy; D018566:Pregnancy, High-Risk
D010926:Placental Hormones