Diagnosis of intrauterine fetal growth retardation by prolongation of dehydroepiandrosterone sulfate (DHAS) half-life after DHAS loading.

Abstract

In the last trimester of pregnancy, a correlation was established between the serum dehydroepiandrosterone sulfate (DHAS) half-life of the mother (n = 40) after DHAS loading (50 mg i.v.) and the birth weight percentile of the newborn. The DHAS half-life in pregnancies with normal fetal growth (greater than 10th percentile) was found to be 3.76 +/- 0.91 h (mean +/- SD) (n = 29) and in pregnancies with small-for-date babies (less than 10th percentile) was assessed to be 6.03 +/- 0.63 h (mean +/- SD) (n = 10) (P less than 0.001). Retrospective diagnosis of an intrauterine fetal growth retardation or normal fetal growth was based on a DHAS halflife threshold of 4.7 h. Retarded fetal growth was detected in all cases (10/10) by prolonged DHAS half-life (greater than r.7 h). Regular fetal growth was diagnosed in 90% of the cases (27/30) by a DHAS half-life of less than 4.7 h. In two out of these 30 pregnancies, an unexpected prolongation of DHAS half-life (greater than 4.7 h) led to the false diagnosis of poor fetal growth. In one patient, no DHAS half-life could be calculated due to a parabolic decline of the DHAS concentration curve. Indications for the DHAS test are diagnosis of an ultrasonographically symmetric intrauterine fetal growth retardation (biparietal and thoracic diameters) in cases with an indefinite gestational age. Furthermore, consistently low urinary excretion was clarified with particular respect to cases of placental sulphatase deficiency.

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