Tests for Estriol Level

8/9/2019 Tests for Estriol Level

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Estriol


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y Estriol can be measured in maternal blood or urine and canbe used as a marker of fetal health and wellbeing. DHEA-Sis produced by the adrenal cortex of the fetus. This isconverted to estriol by the fetal liver.

y If levels of "unconjugated estriol" are abnormally low in apregnant woman, this may indicate a chromosomal or

congenital anomalies like Down syndrome or Edward'ssyndrome. It is included as part of the triple test &quadruple test for antenatal screening for fetal anomalies.

y Because many pathological conditions in a pregnantwoman can cause deviations in estriol levels, thesescreenings are often seen as less definitive of fetal-placental

health than non-stress testing. Conditions which cancreate false positives and false negatives in estriol testingfor fetal distress include preeclampsia, anemia andimpaired kidney function.


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Triple Screen TestyAlso Known as Triple Test, MultipleMarker Screening andAFP Plus

yThe triple screen test is a maternal bloodscreening test that looks for three specificsubstances: AFP, hCG, and Estriol.

y It is a non-invasive procedure done througha blood test with little to no known risk tothe mother or developing baby.


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yAFP: alpha-fetoprotein is a protein thatis produced by the fetus.

yhCG: human chorionic gonadotropin isa hormone produced within theplacenta

yEstriol: estriolis an estrogen producedby both the fetus and the placenta


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What is a screening test?y It is very important to remember what a screening test

is before getting one performed. This will help alleviate

some of the anxiety that can accompany test results.Screening tests do not look only at results from theblood test. They compare a number of differentfactors (including age, ethnicity, results from bloodtests, etc...) and then estimate what a persons chances

are of having an abnormality. These tests DO NOTdiagnose a problem; they only signal that furthertesting should be done.


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What are the risks and side effects

to the mother or baby?

yExcept for the discomfort of

drawing blood, there are noknown risks or side effects

associated with the triplescreen test.


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yAll pregnant women should be offered the triplescreen, but it is recommended for women who:

y Have a family history of birth defects

yAre 35 years or older

y Used possible harmful medications or drugsduring pregnancy

y Have diabetes and use insulin

y Had a viral infection during pregnancyy Have been exposed to high levels of radiation


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What does the triple screen test

look for?y The triple screen is measuring high and low levels

of AFP and abnormal levels of hCG and estriol.

The results are combined with the mother's age,weight, ethnicity and gestation of pregnancy inorder to assess probabilities of potential geneticdisorders.

y High levels of AFP = has a neural tube defect suchas spina bifida or anencephaly. However, the mostcommon reason for elevated AFP levels isinaccurate dating of the pregnancy.


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y Low levels of AFP and abnormal levels of hCGand estriol = Trisomy 21( Down syndrome),Trisomy 18 (Edwards Syndrome) or anothertype of chromosome abnormality.

y primary reason for conducting the test is toSCREEN FOR GENETIC DISORDERS, theresults of the triple screen can also be used toidentify:

yA multiples pregnancyy Pregnancies that are more or less advanced

than thought


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What do the triple test results

mean?

yIt is important to remember that thetriple test is a SCREENING TEST AND

NOT A DIAGNOSTIC TEST. This testonly notes that a mother is at a possibleriskof carrying a baby with a genetic

disorder. The triple screen test isknown to have a high percentage ofFALSE POSITIVE RESULTS.


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y

Abnormal test results warrantadditional testing for making adiagnosis. A more conservativeapproach involves performing a secondtriple screen followed by a highdefinition ultrasound. If the testingstill maintains abnormal results, a

more invasive procedure likeamniocentesis may be performed.


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What are the reasons for further

testing?yThe reasons to pursue further testing or notvary from person to person and couple to

couple. Performing further testing allows youto confirm a diagnosis and then provides youwith certain opportunities:y Pursue potential interventions that may exist

(i.e. fetal surgery for spina bifida)y Begin planning for a child with special needs


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y

Start addressing anticipated lifestylechanges

y Identify support groups and resources

yMake a decision about carrying the childto term

ySome individuals or couples may elect notto pursue testing or additional testing for

various reasons:yThey are comfortable with the results no

matter what the outcome is


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SALIVA TESTINGy an accurate and simple way for the ordinary

man or women to assess the current levels of

steroid hormonesySteroid Hormones in saliva reflect the

portion of circulating hormones in the

bloodstream that are unbound by serumbinding proteins (free or bioavailable) andtherefore are able to enter tissuesthroughout the body.


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y Salivary Hormone Values, therefore, reflect the

biologically active (the unbound) portion available totarget cells. Blood hormone assays reflect both boundand free forms of hormones and do not provideinformation about the bioavailable fraction ofhormone, which can vary depending on the level of

blood hormone binding proteins.y Saliva Hormone Testing tells us the amount of

hormones in our body that are actually usable by ourcells; where as blood testing evaluates all circulatinghormones regardless of their availability to our cells -and most importantly anyone can take a Saliva Testfrom the comfort of their home. It's safe and easy todo.


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y 3.MEN & WOMEN on any hormones need to allow 12- 24 hours after application or ingestion before taking

the test. The use of these hormones needs to be notedon the requisition form (eg. thyroid, estrogen, corticosteroids, progesterone cream). Testing while onhormones will tell you if your program is working.


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Results

yIn urine: estrone = 1.5; estradiol =

1.8; estriol = 3.0(mcg/24 hoururine)

yIn plasma: estrone = 0.05; estradiol= 0.07; estriol = 1.0 (mcg/100ml)

Tests for Estriol Level

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