Value of estriol estimations in the management of diabetic pregnancy

Urinary estriol levels were obtained from 31 normal pregnant women and from 186 women attending the prenatal/diabetic clinic. The latter included 137 Class A (studied in three groups according to the degree of carbohydrate intolerance present), 32 Class B, 7 Class C, and 10 Class D patients. The results were not used to influence the clinical management. Mean values for the entire abnormal group were calculated weekly from 28 weeks until term. These values were used as the basis for comparison of the different classes studied. Only Classes C and D demonstrated depressed levels of excretion. Sixteen perinatal deaths occurred and 9 were considered avoidable had the estriol results been taken into consideration. The “estriol-preventable deaths” are described in detail. It is concluded that the assay presents a potentially valuable adjunct to the clinical management of the pregnant patient with disordered carbohydrate metabolism.