Is measurement of placental function and maternal weight worth while?

Abstract

A prospective survey of 1029 women delivered during 1976 at St. Bartholomew's Hospital was undertaken to assess the predictive value of a variety of clinical, ultrasonic, and biochemical variables in the detection of high-risk pregnancies. The best antenatal predictors of fetal risk were severe pre-eclampsia, depressed maternal serum levels of human placental lactogen, low maternal weight at 32 weeks' gestation, and heavy smoking by the mother. 62% of the high-fetal risk group had one or more of these features, but so did 33% of the controls.

PIP: A prospective survey of 1029 women delivered during 1976 at St. Bartholomew's Hospital (London) was conducted in order to assess the predictive value of a variety of clinical, ultrasonic, and biochemical variables in the detection of high-risk pregnancies. When analysis was confined to maternal weight at 32 weeks, smoking, pre-eclampsia, maternal age, and human placental lactogen, 62% of the high-fetal-risk group was predicted accurately, and false-positive results occurred in 33% of the controls. The findings support the conclusion that routine placental function testing and maternal weighting are worthwhile. It is unlikely that the prediction of fetal risk can be improved by clinical indices, and the addition of other screening procedures such as ultrasonography in the 3rd trimester and monitoring of movement, breathing, and heart-rate patterns in the fetus might increase the prediction-rate.