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Predictive Value of Hormone Measurements in Maternal and Fetal Complications of Pregnancy

Chair of Obstetrics and Gynecology (F.P.), University of Siena, 53100 Siena, Italy; Department of Obstetrics and Gynecology (D.D.), University of Padua, 35128 Padua, Italy; and Department of Obstetrics and Gynecology (F.M.R.), University of Minas Gerais, Belo Horizonte 30130-100, Brazil

Correspondence: Address all correspondence and requests for reprints to: Felice Petraglia, M.D., Chair of Obstetrics and Gynecology, University of Siena Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy. E-mail: petraglia{at}unisi.it

Intrauterine tissues (placenta, amnion, chorion, decidua) express hormones and cytokines that play a decisive role in maternal-fetal physiological interactions. The excessive or deficient release of some placental hormones in association with gestational diseases may reflect an abnormal differentiation of the placenta, an impaired fetal metabolism, or an adaptive response of the feto-placental unit to adverse conditions. This review is focused on the applicability of hormone measurements in the risk assessment, early diagnosis, and management of pregnancies complicated by Down’s syndrome, fetal growth restriction, preeclampsia, preterm delivery, and diabetes mellitus. Combined hormonal tests or the combination of hormones and ultrasound may achieve reasonable sensitivity, but research continues to simplify the screening programs without sacrificing their accuracy. Only in a few instances is there sufficient evidence to firmly recommend the routine use of hormone tests to predict maternal and fetal complications, but the judicious use of selected tests may enhance the sensitivity of the risk assessment based solely on clinical and ultrasound examination.

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