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April 8, 1983

Maternal Hormone Measurements-Reply

Author Affiliations

Puyallup, Wash

JAMA. 1983;249(14):1828. doi:10.1001/jama.1983.03330380026017

In Reply.—  I appreciate the opportunity to respond to Dr Clepper, who commented on the use of maternal hormone measurements, specifically estrogens, in the management of high-risk pregnancies. The topic has been discussed with him previously.1 Since that time, no great breakthrough has been made in this field; as a matter of fact, many clinicians have abandoned estrogen measurements as a result of their often disappointing experiences and based on the results of our prospective controlled study.2 Nevertheless, there are institutions in which estrogens are still used in the management of high-risk pregnancies.Dr Clepper agrees with us about a high incidence of low estrogen values in healthy fetuses. However, he insists that the incidence of falsenegative results, ie, normal values in the presence of fetal jeopardy, is low. The accuracy of this statement depends on the definition of fetal jeopardy. There is no doubt that with a dying