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Clinical Chemistry in Pregnancy

  1. Anthony H Taylor,
  2. Sarah E Melford,
  3. Justin C Konje

Published Online: 15 JAN 2013

DOI: 10.1002/9780470015902.a0023397



How to Cite

Taylor, A. H., Melford, S. E. and Konje, J. C. 2013. Clinical Chemistry in Pregnancy. eLS. .

Author Information

  1. University of Leicester, Leicester, Leicestershire, UK

Publication History

  1. Published Online: 15 JAN 2013


During pregnancy, a woman undergoes a multitude of normal physiochemical changes that are specific to pregnancy and with increasing frequency, challenged with pregnancy-related conditions. Additionally, there are a number of problems affecting the unborn fetus that, in turn, affect normal maternal biochemistry, endocrinology and physiology. Furthermore, normal biochemical, hormonal and clinically relevant measurements for the nonpregnant state often no longer apply to the pregnant woman. This makes clinical laboratory measurement difficult and normal clinical diagnosis using nonpregnant values potentially dangerous, with inappropriate treatment (when it is not required) and no treatment (when it is required) being offered. Problems within early pregnancy, for example, spontaneous and recurrent miscarriage, thus become very complicated to predict or treat. Therefore, reexamining what clinical chemical tests are available and what is just emerging from the experimental laboratory (and thus becoming available in the standard clinical laboratory), should inform the unwary clinician.

Key Concepts:

  • ‘Normal’ pregnancy biochemical marker (Biomarker) concentrations fluctuate throughout pregnancy.

  • No single maternal biomarker can be used to predict gestational disease.

  • Both the concentrations of urinary, serum, plasma, salivary and amniotic fluid biomarkers and the timing of clinical sampling are critical in disease diagnosis.

  • Many new biomarkers are emerging, which may help aid the prediction/diagnosis of pregnancy-related conditions.


  • pregnancy;
  • clinical chemistry;
  • human chorionic gonadotrophin;
  • human placental lactogen;
  • oestrogen;
  • progesterone;
  • anandamide;
  • endocannabinoid;
  • PAPP-A;
  • alpha fetoprotein