Unconjugated estriol - fetal death marker

Unconjugated estriol - fetal death marker
Introduction
Estrogens play an important role in the growth and maintenance of female phenotype, germ cell maturation, and pregnancy. They are also involved in many specific non-gender-specific functions in men and women, including growth, maturation of the nervous system, bone metabolism, and vascular endothelial sensitivity.
Estradiol (E2) estrogen is the body's strongest natural estrogen, followed by estrone (E1), and (E3) estriol is only about 20% of the E2 molecule, It has estrogen receptors. In non-pregnant men and women, E1 and E2 are mainly derived from the androgenic steroids (testosterone and androstenedione, respectively).
Most of the estrogen E3 is derived from E2 and less than 16a metabolites, E1.
Estrogens E1 and E2 are converted to each other and inactivated through hydroxylation or conjugation processes.
During pregnancy, E3 is dominated by estrogen, first produced and secreted in the adrenal glands of the fetus DeHydroEpiandrosterone-Sulfate (DHEAS), and then in the placenta becomes non-conjugated E3 and enters the mother's bloodstream. .
The half-life of uE3 in the mother's blood is 20 to 30 minutes and is rapidly converted to conjugated E3 in the liver of the fetus, which makes it more soluble in water and increases its urinary excretion.
Its level increases throughout pregnancy and peaks at the end of pregnancy. Decreased hormone levels in the second trimester of pregnancy are an indicator of Down syndrome and Edward's syndrome. .
Clinical value of fetal death marker
This marker is a vital element in the diagnosis of steroid metabolic disorders during pregnancy and can be a sign of disorders such as:
1- Smith-Lemli-Opitz Syndrome
2. X-linked ichthyosis, which is found mainly in male fetuses.
3. Contiguous gene syndrome, also called placental sulfatase deficiency disorders.
4- aromatase deficiency
5- primary or secondary fetal adrenal insufficiency
6- Trisomy 18 (as a reduction)
7- and various types of congenital adrenal hyperplasia (including corticosteroid therapy in the mother)
8- Its low levels are seen in major neurological disorders such as anencephaly.
What does an increase in uE3 indicate?
High levels of this hormone or its sudden increase (CMoM> 3.0) indicate early childbirth (pending labor).
This increase is seen approximately four weeks before the onset of labor, which is a more accurate indicator than clinical evaluation. .
As a result, it is used to assess the risk of preterm labor risk.
Failure to increase it in the low-risk group reduces the risk of preterm delivery by 98% and in the high-risk group by 96%.
Its high levels are seen in various types of congenital adrenal hyperplasia.
Fetal death markers are also used to assess the risk of preterm delivery, miscarriage, and fetal demise.
It is used in non-pregnant women to calculate breast cancer risk by measuring markers (estrone (E1, estradiol (E2)) and other metabolites.
It is also used in men and women as a marker for assessing the risk of osteoporosis and hormone therapy in women.
-
The latest concept from the Association of Maternal and Fetal Medicine (SMFM) in 2017 on ultrasound soft markers of aneuploid disorders
-
Important points of the joint SOGC-CCMG guideline - No. 348, September 2017
-
Increases in AFP during pregnancy
-
The effect of father's age on increasing the risk of Down syndrome
-
An overview of new pregnancy screening tips
-
Launch of cffDNA or NIPT testing in Iran under the license of Premaitha UK
-
Essential Basics of Pregnancy Screening
-
Two stage Perinatal screening
-
Second Trimester Screening or Quad Marker
-
First Trimester Screening (FTS)