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. 2012 Aug 15;2012(8):CD000108.
doi: 10.1002/14651858.CD000108.pub2.

Biochemical tests of placental function for assessment in pregnancy

James P Neilson  1
Affiliations

Biochemical tests of placental function for assessment in pregnancy

James P Neilson. Cochrane Database Syst Rev. .

Abstract

Background: Biochemical tests of placental or feto-placental function were widely used in the 1960s and 1970s in high-risk pregnancies to try to predict, and thus try to avoid, adverse fetal outcome.

Objectives: To assess the effects of performing biochemical tests of placental function in high-risk, low-risk, or unselected pregnancies.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (10 May 2012).

Selection criteria: Controlled trials (randomized or 'quasi-randomized') that compare the use of biochemical tests of placental function in pregnancy with non-use.

Data collection and analysis: Trial quality was assessed and data were extracted by the review author.

Main results: A single eligible trial of poor quality was identified. It involved 622 women with high-risk pregnancies who had had plasma (o)estriol estimations. Women were allocated to have their (o)estriol results revealed or concealed on the basis of hospital record number (with attendant risk of selection bias). There were no obvious differences in perinatal mortality (relative risk (RR) 0.88, 95% confidence interval (CI) 0.36 to 2.13) or planned delivery (RR 0.97, 95% CI 0.81 to 1.15) between the two groups.

Authors' conclusions: The available trial data do not support the use of (o)estriol estimation in high-risk pregnancies. The single small trial available does not have the power to exclude a beneficial effect but this is probably of historical interest since biochemical testing has been superseded by biophysical testing in antepartum fetal assessment.

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Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 1 Fetal death.
1.2
1.2. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 2 Neonatal death.
1.3
1.3. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 3 Perinatal death.
1.4
1.4. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 4 Induction of labour.
1.5
1.5. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 5 Elective caesarean section.
1.6
1.6. Analysis
Comparison 1 Oestriol levels reported versus not reported, Outcome 6 Planned delivery.
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References

References to studies included in this review

Duenhoelter 1976 {published data only}
    1. Duenhoelter JH, Whalley PJ, MacDonald PC. An analysis of the utility of plasma immunoreactive estrogen measurements in determining delivery time of gravidas with a fetus considered at high risk. American Journal of Obstetrics and Gynecology 1976;125:889‐98. - PubMed

References to studies excluded from this review

Grudzinskas 1990 {unpublished data only}
    1. Grudzinskas JG. To assess the effects of biochemical placental function testing. Personal Communication 1990.
Sharf 1984 {published data only}
    1. Sharf M, Eibschitz I, Hakim M, Degani S, Rosner B. Is serum free estriol measurement essential in the management of hypertensive disorders during pregnancy?. European Journal of Obstetrics & Gynecology and Reproductive Biology 1984;17:365‐75. - PubMed
Spellacy 1975 {published data only}
    1. Spellacy WN, Buhi WC, Birk SA. The effectiveness of human placental lactogen measurements as an adjunct in decreasing perinatal deaths. Results of a retrospective and randomized controlled prospective study. American Journal of Obstetrics and Gynecology 1975;121:835‐44. - PubMed

Additional references

Alexander 1989
    1. Alexander S, Stanwell‐Smith R, Buekens P, Keirse MJNC. Biochemical assessment of fetal well‐being. In: Chalmers I, Enkin MW, Keirse MJNC editor(s). Effective care in pregnancy and childbirth. Vol. 1, Oxford: Oxford University Press, 1989:455‐76.
Alfirevic 1995
    1. Alfirevic Z, Neilson JP. Doppler ultrasonography in high‐risk pregnancies: systematic review with meta‐analysis. American Journal of Obstetrics and Gynecology 1995;172:1379‐87. - PubMed
Alfirevic 2002
    1. Alfirevic Z, Neilson JP. Biophysical profile for fetal assessment in high risk pregnancies. Cochrane Database of Systematic Reviews 2002, Issue 2. - PubMed
Chard 1982
    1. Chard T, Klopper A. Placental function tests. Berlin: Springer‐Verlag, 1982.
Clarke 2001
    1. Clarke M, Oxman AD, editors. Cochrane Reviewers’ Handbook 4.1 [updated June 2000]. In: Review Manager (RevMan) [Computer program]. Version 4.1. Oxford, England: The Cochrane Collaboration, 2000.
Greene 1965
    1. Greene JW Jr, Duhring JL, Smith K. Placental function test. A review of methods available for assessment of the fetoplacental complex. American Journal of Obstetrics and Gynecology 1965;92:1030‐58. - PubMed
Luckas 1998
    1. Luckas MJ, Sandland R, Hawe J, Neilson JP, McFadyen IR, Meekins JW. Fetal growth retardation and second trimester maternal serum human chorionic gonadotrophin levels. Placenta 1998;19:143‐7. - PubMed
Neilson 2002
    1. Neilson JP, Alfirevic Z. Doppler ultrasound for fetal assessment in high risk pregnancies. Cochrane Database of Systematic Reviews 2002, Issue 2. - PubMed
Pattison 2002
    1. Pattison N, McCowan L. Cardiotocography for antepartum fetal assessment. Cochrane Database of Systematic Reviews 2002, Issue 2. - PubMed
RevMan 2000 [Computer program]
    1. The Cochrane Collaboration. Review Manager (RevMan). Version 4.1 for Windows. Oxford, England: The Cochrane Collaboration, 2000.

References to other published versions of this review

Neilson 1995
    1. Neilson JP. Hormonal Placental Function Tests [ revised 12 May 1994]. In: Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds) Pregnancy and Childbirth Database [database on disk and CDROM]. The Cochrane Collaboration; Issue 2, Oxford: Update Software; 1995.
Neilson 1997
    1. Neilson JP, Cloherty LJ. Hormonal placental function tests for fetal assessment in high risk pregnancies. Cochrane Database of Systematic Reviews 1997, Issue 2. - PubMed

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