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April 8, 1983

Maternal Hormone Measurements

Author Affiliations

The Medical Center Columbus, Ga

JAMA. 1983;249(14):1828. doi:10.1001/jama.1983.03330380026016

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To the Editor.—  In a recent reply in the QUESTIONS AND ANSWERS section of The Journal (1982;248:1109) relating to the use of maternal hormone measurements in the management of high-risk pregnancies, Duenhoelter correctly emphasizes the high incidence of false-positive results (ie, low values in the absence of fetal jeopardy) from maternal estriol and human placental lactogen assays. However, I believe that the companion assertion of a high incidence of false-negative estriol results would probably be challenged by most contributors to this area of inquiry. In fact, properly performed (radioimmunoassay) serum or urine estriol assays have low incidences of false-negative results (normal values in the presence of fetal jeopardy), probably lower than any of the other chemical or biophysical measurements.Even so, one cannot predict how long the safety inherent in a normal estriol value will last, in contrast, for instance, to the five- to seven-day assurance offered by a normal