Cochrane Reviews

Hormonal placental function tests for fetal assessment in high risk pregnancies Neilson JP, Cloherty U (In: The Cochrane Library, Issue 4, 2001. Oxford: Update Software) Background: Biochemical tests of fetal well-being such as placental hormone levels have not always shown direct benefits for mothers and babies. A wide range of biochemical tests of fetal well-being have been introduced during the last 50 years, but there is little agreement on their usefulness (1). In general, biochemical tests have been used for screening, diagnostic follow-up and for deciding the need for intervention (1). The concept underlying all of these tests has remained remarkably similar throughout the years. It is assumed that accurate measurement of" metabolic changes should logically be useful in the determination of the fetal status and could help reduce perinatal mortality rates" (2). Undoubtedly, biochemical tests of fetal well-being have contributed greatly to current understanding of the endocrinology and physiology of pregnancy, but this has not necessarily been matched by direct benefits for mother and child. Objective: The objective of this review was to assess the effects of measuring placental hormone levels during high risk pregnancies. Search strategy: The authors searched the Cochrane Pregnancy and Childbirth Group trials register and MEDLINE. They also contacted study authors. Selection criteria: Adequately controlled trials comparing availability with no availability of hormone placental tests in high risk pregnancy. Data collection and analysis: Trial quality was assessed and data were extracted by two reviewers and this was checked by a colleague. Study authors were contacted for additional information. Main results: Two trials (3, 4) involving 3355 women were included. Methodological quality of the trials was acceptable, but results for only 230