Serial Number Idm 6.11 Build 50

[Adrienne Borgman]

Available methods for fetal antenatal assessment in diabetic pregnancies include biochemical (urinary estriols), bioelectric (antepartum fetal heart rate testing), and biophysical (ultrasound) modalities. Biochemical tests, specifically serial urinary estriol determinations, have served as the standard of fetal well-being against which the value of fetal heart rate testing has been compared. Recent reports, however, have seriously questioned the value of estriol determinations as the standard. Dooley and associates observed drops in the estriol:creatinine ratio of 40% or greater in only 0.6% of tests (19 of 3085) and found that only two of these abnormal drops correctly predicted fetal distress.84 Thus, the high numbers of false-positive estriol drops precludes clinical usefulness of the test in the management of pregnant diabetics. Further, the cost of serial estriols is high and there is a delay in obtaining laboratory results. Golde and associates used bioelectric and biophysical testing to manage insulin-dependent diabetic pregnant women.85

serial number idm 6.11 build 50
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