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Biochemical amniotic fluid pattern for prenatal diagnosis of esophageal atresia.
MedLine Citation:
PMID:  21522036     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Prenatal diagnosis of esophageal atresia (EA) may improve the outcome of affected neonates by allowing optimization of both prenatal and postnatal care. Prenatal sonographic detection is based on polyhydramnios and/or nonvisualization of the fetal stomach bubble, two signs with a large number of etiologies. We evaluated a biochemical approach to improving diagnostic efficiency. We compared amniotic fluid biochemical markers in 44 EA cases with 88 polyhydramnios and 88 non-polyhydramnios control cases, both matched for gestational age with EA cases. Total proteins, alpha-fetoprotein (AFP) and digestive enzyme activities were assayed, including gamma-glutamyl transpeptidase (GGTP). We defined an EA index (AFP multiplied by GGTP). A significant difference (P <0.0001) was observed for total protein, AFP, GGTP, and EA index between the EA group and each of the two control groups. No statistical difference was observed for any maker between the two most frequent EA sub-groups (type I and type III), or between the two control groups. Using a cut-off of 3 for the EA index, 98% sensitivity and 100% specificity were observed for amniotic fluid prenatal diagnosis of EA, whatever the anatomical type. A large prospective series is required to confirm these results. LIST OF ABBREVIATIONS::
Authors:
Isabelle Czerkiewicz; Sophie Dreux; Anaïs Beckmezian; Alexandra Benachi; Laurent J Salomon; Thomas Schmitz; Arnaud Bonnard; Naziha Khen-Dunlop; Françoise Muller
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-25
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Biochimie-Hormonologie [I.C., S.D., F.M.], Gynécologie-Obstétrique [A.Bec., T.S.], Chirurgie Pédiatrique [A.Bo.], Hôpital Robert Debré, AP-HP, Université Paris Ile de France Ouest, Paris, 75019, France; Gynécologie-Obstétrique [A.Ben.], Hôpital Antoine Béclère, AP-HP, Université Paris XI, Clamart, 92140, France; Gynécologie-Obstétrique [L.J.S.], Chirurgie Pédiatrique [N.K-D.],Necker-Enfants Malades, AP-HP, Université Paris V, Paris, 75015, France.
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