Qaytarish

Estriol (E3), erkin (kon'yugatsiyalanmagan)

Kod:9022|CPT:82677|LOINC:2251-7

Sinonimlar
Неконъюгированый эстриолнесвязанный эстриолE3Free estriolUnbound estriolUnconjugated estriol
KabiEstriol, qon zardobi

Tahlil ma'lumotlari

Tadqiqot usuli

  • Immunokimyoluminometrik analiz (ICMA)
  • Kimyoluminessent immunoanaliz (CLIA)

Kutilayotgan natija topshirish vaqti

1 kun

Maxsus tayyorlik

  • Record the gestational age in weeks on the test requisition.
  • When clinically warranted, collect serial specimens to follow trends.
  • Avoid strenuous activity and minimize emotional stress for 30 minutes before phlebotomy.
  • Do not smoke during the 30 minutes before specimen collection.

Qanday foydalanish

Estriol (E3) tahlili — erkin yoki bog'lanmagan estriol deb ham ataladi — platsenta faoliyati va homila holatini baholash uchun qo'llanadi, ayniqsa preeklampsiya, homila o'sishining cheklanishi, qandli diabet, Rh izoimmunizatsiyasi va trofoblast kasalligi (gidatidiform mola, xoriokarsinoma) bilan asoratlangan homiladorliklarda. Ikkinchi trimestrdagi maternal zardob skriningida alfa-fetoprotein va hCG bilan birga estriol trisomiya 21, trisomiya 18 va ochiq nerv naychasi nuqsonlari xavfini baholashga hissa qo'shadi. Klinik qaror qabul qilishda ketma-ket o'lchovlar afzal hisoblanadi. Past konsentratsiyalar anensefaliya yoki platsentar sulfataza yetishmovchiligi bilan kuzatilishi mumkin, ko'p homilali homiladorlikda esa darajalar yuqoriroq bo'lishi mumkin. Homiladorlikdan tashqarida, tuxumdon, moyak yoki buyrak usti bezining estrogen ishlab chiqaruvchi o'smalari bilan darajalar ancha yuqori bo'lishi mumkin.

Cheklovlar

Kon'yugatsiyalanmagan estriol normal gestatsiyaning ustun estrogeni bo'lib, homila va platsentaning integrallashgan faoliyatini aks ettiradi. Platsentada steroidogenezning to'liq yo'li mavjud emasligi sababli u prekursorlarga — asosan ona va homila DHEA‑Siga — tayanadi; platsentar estriolning taxminan 90% i homila jigari metabolizmiga bog'liq. Homiladorlik davom etishi bilan ona zardobidagi konsentratsiyalar ortadi va sutkalik tebranishni ko'rsatadi; talqin gestatsion yoshga xos kontekstda amalga oshirilishi lozim, yakka natijalardan ko'ra ketma-ket trendlar afzal. Estriolning pasayishi anensefaliya yoki platsentar sulfataza yetishmovchiligi bilan kuzatilishi mumkin, ko'p homilali homiladorlikda esa yuqoriroq qiymatlar kutiladi. Estriol alfa-fetoprotein va hCG bilan birga ikkinchi trimestr skriningiga kiritilib, ko'p uchraydigan xromosomal anomaliyalar va tuzilmaviy nuqsonlar ehtimolini baholash uchun ishlatiladi. Homiladorlikdan tashqarida juda yuqori qiymatlar tuxumdon, moyak yoki buyrak usti bezining estrogen sekretsiya qiluvchi o'smalari bilan bog'liq bo'lishi mumkin. Yakka o'lchovlarni talqin qilish qiyin; odatda trend tahlili ko'proq ma'lumot beradi.

O'lchov birliging/mL
Referens oraliq
MinMaks
–0.85
Ko'rsatmalarSecond‑trimester maternal serum screening to estimate risk for trisomy 21, trisomy 18, and open neural tube defects, Assessment of suspected placental insufficiency, fetal growth restriction, or possible intrauterine fetal demise, Monitoring of pregnancies at increased risk: maternal age ≥35 years; multifetal gestation; prior fetus with chromosomal aneuploidy; maternal HIV infection; assisted reproduction; tobacco use; pregestational diabetes mellitus, Risk stratification or evaluation when late‑pregnancy complications are suspected, including preeclampsia and placental abruption, Evaluation of hyperestrogenic states (e.g., abnormal uterine bleeding in women; gynecomastia in men)

Natija og'ishlarining mumkin sabablari

Oshgan daraja

  • advancing gestational age
  • hydrops fetalis
  • multiple gestation
  • oxytocin

Pasaygan daraja

  • anencephaly
  • anemia
  • high altitude
  • placental sulfatase deficiency
  • severe liver disease

Namunangiz talablari

NamunangizZardob
ContainerOltin/yo'lbars qopqoqli probirka (SST, gel ajratgich)
Hajm1 mL (min 0.3 mL)
Saqlash tayyorlikXona harorati, Sovutilgan, Muzlatilgan

References

Bashore RA, Westlake JR. Plasma unconjugated estriol values in high-risk pregnancy. Am J Obstet Gynecol. 1977 Jun 15;128(4):371-380.

Bennett DB, Wells DJ. Endocrinology. In: Bishop ML, Duben-VonLaufen JL, Fody EP, eds. Clinical Chemistry: Principles, Procedures, Correlations. Philadelphia, Pa: JB Lippincott Co; 1985:307-343.

Perinatal Services BC Obstetrics Guidiline 17 Prenetal screening for Down syndrome, trisomy 18 and open neural tube defects.

Rachel K Morris et al. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: Systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2008;8:33.

Shanbhogue AK et al. Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 2010 Jul-Aug;30(4):903-19.

Chernecky CC, Berger BJ. Laboratory Tests and Diagnostic Procedures. 5th ed. Saunders Elsevier; 2008.

DeVita VT, Lawrence TS, Rosenberg SA. Principles and Practice of Oncology. 8th ed. Lippincott Williams & Wilkins; 2008.