[The value of the dynamic dehydroepiandrosterone-test compared to the static measurement of total urinary estrogen excretion in the diagnosis of the condition of the feto-placental-unit (author's transl)].

In a comparative study in 84 pregnant women the condition of the feto-placental-unit was examined through the utilization of the DHEA-test and by the measurement of total urinary estrogen excretion. The test consists of intravenous injection of 50 mg DHEA-S to the mother and measurement of the total estrogen increase during the following 24 hour period as compared to the values before injection. When the condition of the feto-placentalunit is good an increase of estrogens is seen as a consequence of the transformation of DHEA to estrogens by the placenta. The difference between total urinary estrogen excretion before and after the injection of DHEA is considered as a measure of placental function. The results of estrogen determinations and the DHEA test were correlated to placental histology, cardiotocogram, colour of the amniotic fluid, Apgar-score, stillbirth, birthweight, and transfer of newborns to pediatry. We found that in cases with normal estrogen values and especially in cases with a good increase of estrogen excretion following DHEA-S-load there was a high probability of there being no acute risk for the fetus. The DHEA-test has a higher prognostic value than the analysis of urinary estrogen excretion alone, because it is better able to predict pathological findings of the reference parameters cited above. Possible reasons for an insufficient increase of estrogens in the DHEA-test without clinical pathology are discussed. When only a short time remains before birth, a better accord between test-results and clinical findings can be observed. This suggests a weekly repetition of the test.