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Free estriol E3

Known as: Free estriol E3
SKU: 2004


Study material: Venous blood
Response time (working day): 1***
The test is done on an empty stomach: Yes
Home call service: Yes
Country: Georgia

General Information

**** Test is done once a week - Friday

Estriol (E3) Is estrogen present in the blood and urine of a pregnant woman. Circulating estriol (90%) is produced in the placenta from DHEA (dehydroepiandrosterone), which is synthesized in the adrenal glands of the fetus and converted to estriol by the fetal liver and placenta.

Accordingly, estriol levels are a marker for fetal chromosomal pathology (included in the complex of second-trimester biochemical tests with AFP and β-hCG), and for assessing the condition of the fetus and fetoplacental complex. (With placental lactogen levels).

When should we take the test?

Prenatal biochemical screening - a marker of chromosomal pathology of the fetus (II trimester).

Fetal and fetoplacental complex condition marker:

  • All pregnant women undergo prenatal screening to determine the possible presence of chromosomal abnormalities in the fetus. Considering neural tube defects in the second trimester of pregnancy, along with other tests (AFP, hCG). This test is used as part of biochemical screening for the second trimester. The optimal examination period is 16 - 18 weeks;
  • Ultrasound data to assess possible placental pathology, fetal developmental pathology, and fetoplacental complex status (assessment of hormone level dynamics in combination with placental lactogen level);
  • Monitoring the status of the fetoplacental complex in the presence of extragenital pathology of the mother: diabetes, preeclampsia, rhesus conflict.

Possible interpretation of the results

Level increase:

  • Multiple pregnancy;
  • Large fruits;
  • Initial stage of fetoplacental insufficiency;
  • Liver disease (reduced conjugation of estriol)

Level decrease:

  • Down Syndrome, Edwards Syndrome;
  • Fetal anencephaly;
  • Progressive fetoplacental insufficiency
  • Risk of termination of pregnancy or premature birth;
  • Delayed childbirth;
  • Hypoplasia of the fetal adrenal glands;
  • Intrauterine infection;
  • Taking glucocorticoids and antibiotics by a pregnant woman.

Significant drop (less than 0.01 MoM):

  • Placental sulfatase deficiency in X-linked ichthyosis;
  • Smith-Lampley-Opitz syndrome (disorders of sex hormone synthesis);
  • Fetal death.

Additional information

Circulating estriol is mainly present in the conjugated form, which is excreted in the urine, with free estriol (unconjugated) accounting for about 9% of the total. Under normal conditions of fetal development, estriol production gradually increases, reaching a maximum at 36 weeks of gestation (pregnancy), however, significant individual fluctuations in levels are noted, so it is recommended to focus not on one-time determination of hormones but on the dynamics of hormone levels.

Low estriol levels, degenerative dynamics, or a sharp drop in levels indicate the presence of fetal pathology (chromosomal pathology, fetal intrauterine growth retardation, fetal adrenal pathology) or fetoplacental abnormalities (expected).

The combined determination of unconjugated estriol (E3), chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) in the second trimester of pregnancy is a study known as the "triple test". In addition to maternal clinical data and data from other studies, it is used as a screening study to assess the risk of chromosomal abnormalities in the fetus and is included in a set of biochemical markers.

The test must be performed On an empty stomach (On an empty stomach). The patient should indicate the date of the last menstrual period or the gestational (pregnancy) age determined by the ultrasound.


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