Practical screening for the dysfunctional feto-placental unit during pregnancy

Abstract

In threatened abortion which terminated in fetal loss, 'the point' moved to the lower left part on the 'table'. On the other hand, in cases with favorable outcome, 'the point' moved to the right. In molar pregnancy, the hormone pattern was 'high hCG' and 'low hCS' and was different from that in abortion. In cases of anencephalia, congenital enzymatic deficiency of the placenta, and Wharton's jelly defect of the umbilical cord, 'the point' remained in the low estriol zone. With mild toxemia of pregnancy, 'the point' also remained in the low estriol zone. With sensitized rhesus incompatibility, 'the point' gradually moved to the low estriol zone. In cases of placental insufficiency and mild toxemia of pregnancy (hypertensive type), 'the point' moved to the low hCS zone. In cases of chronic hypertension, retarded fetal growth, and aortic insufficiency, 'the point' remained in the low hCS zone. With intrauterine fetal death, 'the point' was always in the absolutely abnormal zone. With severe toxemia of pregnancy, 'the point' moved into the absolutely abnormal zone. In cases of well-controlled diabetic disease or hyperthyroidism, and of rhesus incompatibility with low antibody titers, 'the point' was in the normal zone. In cases with 'the point' present in the low estriol zone, the DHAS dynamic test should be done, and the reserve-function of the feto-placental unit should be evaluated. In cases with 'the point' present in the low hCS zone, it is necessary to use the oxytocin challenge test to assess the reserve-function of the placenta. In conclusion, the effective use of these methods is of value in predicting the dysfunction of the feto-placental unit, and it is hoped that the employment of these methods for the high risk foetus in the early stages might lead to more intensive obstetric care and might contribute to the reduction of perinatal loss.