Reis Fernando M, D'Antona Donato, Petraglia Felice
Department of Obstetrics and Gynecology, University of Minas Gerais, Belo Horizonte 30130-100, Brazil.
Endocr Rev. 2002 Apr;23(2):230-57. doi: 10.1210/edrv.23.2.0459.
Intrauterine tissues (placenta, amnion, chorion, decidua) express hormones and cytokines that play a decisive role in maternal-fetal physiological interactions. The excessive or deficient release of some placental hormones in association with gestational diseases may reflect an abnormal differentiation of the placenta, an impaired fetal metabolism, or an adaptive response of the feto-placental unit to adverse conditions. This review is focused on the applicability of hormone measurements in the risk assessment, early diagnosis, and management of pregnancies complicated by Down's syndrome, fetal growth restriction, preeclampsia, preterm delivery, and diabetes mellitus. Combined hormonal tests or the combination of hormones and ultrasound may achieve reasonable sensitivity, but research continues to simplify the screening programs without sacrificing their accuracy. Only in a few instances is there sufficient evidence to firmly recommend the routine use of hormone tests to predict maternal and fetal complications, but the judicious use of selected tests may enhance the sensitivity of the risk assessment based solely on clinical and ultrasound examination.
子宫内组织（胎盘、羊膜、绒毛膜、蜕膜）会表达一些激素和细胞因子，它们在母胎生理相互作用中起着决定性作用。某些胎盘激素的过度或不足释放与妊娠疾病相关，这可能反映出胎盘分化异常、胎儿代谢受损，或者是胎儿 - 胎盘单位对不良状况的适应性反应。本综述聚焦于激素检测在唐氏综合征、胎儿生长受限、先兆子痫、早产和糖尿病合并妊娠的风险评估、早期诊断及管理中的适用性。联合激素检测或激素与超声检查相结合可能会达到合理的敏感性，但研究仍在继续简化筛查方案且不降低其准确性。只有在少数情况下，才有充分证据坚定推荐常规使用激素检测来预测母胎并发症，但明智地使用特定检测可能会提高仅基于临床和超声检查的风险评估的敏感性。
