Predicting fetal death by measuring oestrogen: Creatinine ratios on early morning samples of urine

Abstract

Total oestrogens were measured, on a creatinine basis, by a fully automated method in 75 000 early morning specimens of urine from 5429 women. Among the 5241 pregnancies in which the oestrogen :creatinine ratio was normal there were 11 fetal deaths (0.21%). But there were 57 fetal deaths (30.3%) among 188 patients with ratios below the fifth centile. When delivery took place before the ratio decreased to below the fifth centile a live baby was born in every one of 59 pregnancies. Apart from its effectiveness in predicting fetal death, the test has a high degree of precision and can be performed swiftly, and cheaply. For these reasons the assessment of fetoplacental function by measuring the urinary: creatinine ratio could become a convenient and inexpensive part of antenatal care that could be extended to every pregnant woman without making many further demands on obstetricians' time. © 1977, British Medical Journal Publishing Group. All rights reserved.