Unconjugated Estriol Estriol E3 is the predominant estrogen hormone in the blood and urine of pregnant women.
The majority of circulating estriol is a product of the placental unit, resulting in a precursor α-hydroxy-dehydroepiandrosterone synthesized in the fetal adrenals and converted into estriol by fetal liver and placenta. The normal production of this hormone is an indicator of placental unit integrity and well-being of the fetus. During normal development of the fetus, estriol production increases progressively, reaching a maximum at 36 weeks of pregnancy.
Sequential monitoring of estriol levels in high risk pregnancies has a higher clinic value than isolated determinations, allowing early therapeutic intervention.
Thus persistent low levels of estriol or a sudden reduction of it may be suggestive of fetal distress. Combined determination of unconjugated estriol, chorionic gonadotropin HCG total or free-beta HCG and alpha-fetoprotein AFP in the second trimester of pregnancy — investigation known as the triple test — has utility, anemia 36 weeks pregnant with other maternal clinical data in predicting risk of fetal abnormalities at birth.
Recommendations for determination of unconjugated estriol — in the triple test; evaluation of fetal distress and placental function in patients who have complications of pregnancy: preeclampsia, fetal growth retardation, diabetes, Rh isoimmunization, hydatidiform mole and choriocarcinoma.
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The low levels of estriol are associated with risk: fetal growth retardation, fetal death, preeclampsia, Rh isoimmunization. Lower levels can be seen in anemia, diabetes, malnutrition, liver disease.
Estriol levels may be reduced in the presence of a living fetus anencephaly. Navigation Menu.