During the 1960s and 1970s, the fetoplacental unit was assessed by means of biochemical studies in the form of oestriol and human placental lactogen assays. With the advent of both real-time ultrasound and fetal heart rate monitoring, the accent on fetal assessment has changed. More recently (the late 1980s) the use of Doppler ultrasound has expanded the non-invasive assessment of the fetoplacental unit. This review discusses these modalities along with reports of randomized controlled trial assessments of these modalities.

The placental perfusion index (PPI) measured I-27 days before delivery was compared with maternal urinary and serum oestriol (OT) and serum human chorial somatomammotropine (HCS) levels in the mothers of 24 newborns born with intrauterine growth retardation. No significant correlation between placental perfusion and the above endocrine parameters was found. Placental perfusion was not reduced in every case of intrauterine growth retardation. Mathematical analysis has shown that hit accuracy can be increased by the use of more endocrine parameters in pathological pregnancy.

Serial Human Chorionic Somatomammotropin (HCS) levels were measured during the last 10 weeks of pregnancy in 57 patients (375 samples). There was a gradual rise from 5.6 microgram/ml at the 30th week to microgram/ml at the 40th week, with a plateau during the last 4 weeks of pregnancy. No correlation could be found of HCS levels with parity, maternal age, maternal height, maternal weight, foetal weight and foetal sex. A weak but significant relationship was found between HCS and plasma oestriol (r = 2.4, p less than 0.001).

The value of sonor biparietal cephalometry and serum oxytocinase that we have obtained with weekly simultaneous determinations in 14 females with normal pregnancy and in 5 with pathological pregnancy, from 24th to 39th week, show a statical positive relation. Serum oxitocinase determination against hormonal tests of the phetoplancental function (urinary oestriol, pregnandiol, serum HCS, ecc.) give advantages: it is the easyer, faster and less espandove determination. Therefore we think that it is helpful to determin togheter serial values of sonar biparietal cephalometry and serum oxytocinase to anticipate the endouterine fetal growth retardation.