Estriol

Estriol (E3) is a metabolite of estradiol and estrone. It is low in non-pregnancy and is mainly synthesized by the liver. It is mainly synthesized by fetal placenta during pregnancy, synthesized through maternal blood circulation, metabolized in the liver, and Sulfuric acid or glucuronic acid combine to form bound E3 and is excreted from the urine. E3 plays an important role in regulating fetal intrauterine development and can affect the sensitivity of the pregnant uterus to oxytocin. Basic Information Specialist classification: maternity check check classification: blood test Applicable gender: whether men and women apply fasting: fasting Tips: Be an empty stomach before doing an inspection. Normal value Pregnant women (0.31 ± 0.17) nmol / L. In pregnant women, it increased with the gestational age of 21 weeks, (15.75 ± 1.74) nmol / L; 35 weeks, (35.26 ± 7.95) nmol / L; 41 ~ 42 weeks, (56.39 ± 11.0) nmol / L. Male (0.24 ± 0.17) nmol / L. Clinical significance (1) Monitoring E3 in patients with diabetes pregnancy helps to understand placental function and fetal development. The incidence of macrosomia in diabetic pregnancies can be increased about 10 times compared with non-diabetic patients, and the secretion of E3 in placenta is increased, resulting in elevated serum or 24h urine E3. The incidence of stillbirth in pregnant women with diabetes is much higher than that in non-diabetic pregnant women, so the change of hematuria E3 level is monitored. Helps determine the optimal delivery period for pregnant women with diabetes. In the third trimester of pregnancy, the concentration of E3 gradually increased slowly, reaching a peak at 41 to 42 weeks. It is generally believed that serum E3 should be greater than 31nmol/L in full-term pregnancy, and <6.9nmol/L in fetuses die in intrauterine, >6.9nmol/L, <13.9nmol/L in fetal crisis. 24h urine <10mg, also suggested that fetal placental function is low. (2) Pregnancy-induced hypertension syndrome In the absence of fetal distress, E3 can remain normal in the early stage due to increased uterine-placental blood flow. In patients with moderate to severe pregnancy-induced hypertension, the activity of renin-angiotensin-aldosterone system is enhanced, which causes placental ischemia and serum E3 can be significantly decreased. (3) Increased serum E3 in multiple pregnancies and overweight fetuses. Serum E3 decreased in expired pregnancy, intrauterine growth retardation, fetal adrenal insufficiency, and stillbirth. Precautions The fasting venous blood was not detected by anticoagulation. The use of the ovulation drug clomiphene, estrogen, etc. can increase the test results. Inspection process 1ml of plasma was added to 6ml of distilled ether, shaken in a centrifuge tube for 2min, centrifuged at 1500r/min for 5min, the upper layer of diethyl ether was divided into two tubes and 2ml per tube, and the ether was blown dry at 45°C, and 50μl of 3H-estratriol was added. The water bath was used at 45°C. Compress air, blow dry each tube and add 1:20,000 diluted antibody (0.2ml per tube), shake and place in a refrigerator at 4°C overnight, take out 5ml/L gelatin 0.1ml per tube the next day, put 4°C ice bath, each The tube was added with 2.5 g/L and DCC 0.5 ml. After 10 min, centrifuge for 3000 r/min for 10 min, aspirate 0.4 ml of the supernatant in 8 ml of scintillation fluid, mix for 1 min on a vortex mixer, and count by scintillation every 4 h. Not suitable for the crowd Have a coagulopathy such as hemophilia. Adverse reactions and risks 1. Subcutaneous hemorrhage: subcutaneous hemorrhage due to less than 5 minutes of compression time or blood draw technique. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye.