The effectiveness of human placental lactogen measurements as an adjunct in decreasing perinatal deaths. Results of a retrospective and a randomized controlled prospective study

Abstract

Serum human placental lactogen (HPL) levels were measured in high-risk pregnancies. A retrospective analysis of 101 gestations with a perinatal loss showed that the 71 stillbirths had abnormally low fetal-danger zone (F-D zone) HPL levels (50.7%) before the fetus died (normal smaller than 1%). With severe hypertension, 85.7% of the cases had F-D zone HPL values prior to fetal death. Abnormal low F-D zone HPL values were found in 20% of the 30 neonatal deaths. A 3 year randomized controlled treatment series was done with 2,7333 women (1,362 treatment and 1,371 control) who had serial serum HPL measurements performed at each prenatal visit. The frequency of F-D zone HPL values was similar (8.6% treatment and 8.2% control). The results showed that although the neonatal mortality rates were similar, the HPL treatment group had a significantly lower fetal death rate (2.6 vs. 14.2%) and thus perinatal mortality rate (3.4 vs. 15.0%). This study supports the usefulness of routine prenatal HPL measurements in the management of high-risk pregnancies.