Establishment of reference values of five amniotic fluid enzymes. Analytical performances of the Hitachi 911. Application to complicated pregnancies

Burc, Laurence; Gadrey, Jean; Luton, Dominique; Noël, Michèle; Beaudeux, Jean-Louis; Oury, Jean‐François; Porquet, Dominique

doi:10.1016/s0009-9120(01)00228-4

Cited by 12 publications

(27 citation statements)

References 16 publications

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“…Amniotic fluid digestive enzymes are considered by some as a valuable prenatal tool to assess the fetal bile apparatus [6,12,14,18]. …”

Section: Discussionmentioning

confidence: 99%

“…Nonvisualization of the fetal gallbladder (NVFGB) may indicate gallbladder agenesis, without any serious clinical sequel [8], or it may be associated with a severe disorder such as extrahepatic biliary atresia (BA) [9,10], cystic fibrosis (CF) [11], chromosomal abnormalities [1,7,12], or other digestive tract disorders carrying a poor prognosis [13,14]. …”

Section: Introductionmentioning

confidence: 99%

“…These activities can only be detected following the opening of the cloacal membrane and intestinal villous maturation, which occurs at about 13-14 weeks of gestation. Reference values have been reported for some of the fetal digestive enzymes, mainly γ-glutamyl transpeptidase (GGTP), which is produced mostly by the liver and the biliary tract [14,15]. Due to anal sphincter maturation, more selective glomerular filtration, and tubular resorption, these enzyme levels start to decrease at 17 weeks of gestation and decrease sharply from 20 weeks of gestation, reaching nearly undetectable levels at 22 weeks of gestation [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Bardin¹,

Ashwal‏²,

Davidov³

et al. 2015

Fetal Diagn Ther

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Objective: In cases of nonvisualization of the fetal gallbladder (NVFGB), we investigated whether amniotic fluid levels of γ-glutamyl transpeptidase (GGTP) can distinguish normal development or benign gallbladder agenesis from severe anomaly such as biliary atresia. Methods: This is a retrospective cohort study of pregnancies in which the gallbladder was not visualized in the second-trimester fetal anatomy scan. Levels of GGTP in amniotic fluid were analyzed prior to 22 weeks of gestation by amniocentesis. Data were collected regarding other fetal malformations, fetal karyotype, and screening results for cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations. Results: Of 32 cases of NVFGB, 27 (84%) had normal GGTP levels and a normal CFTR gene screening, and 1 of them had an abnormal karyotype. Three of the 5 cases with low GGTP were diagnosed with extrahepatic biliary atresia, proven by histopathological examination following termination of pregnancy. The fourth case had hepatic vasculature abnormality and the fifth isolated gallbladder agenesis. In 22 of 32 cases (68.7%), the gallbladder was detected either later in pregnancy or after delivery. Conclusion: The findings support low levels of GGTP in amniotic fluid, combined with NVFGB, as a sign of severe disease, mainly biliary atresia. Normal GGTP levels, concomitant with isolated NVFGB, carry a good prognosis.

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“…Amniotic fluid digestive enzymes are considered by some as a valuable prenatal tool to assess the fetal bile apparatus [6,12,14,18]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Bardin¹,

Ashwal‏²,

Davidov³

et al. 2015

Fetal Diagn Ther

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“…The composition varies throughout gestation: in the first trimester, it is essentially a plasma ultrafiltrate. Later, in the second and third trimesters, the developing renal, urinary, gastrointestinal, and pulmonary organ systems contribute their secretory products to amniotic fluid to yield a more complex matrix (45 ).…”

Section: Alternative Sample Matrices For Fetal Health Assessmentmentioning

confidence: 99%

“…Increases in all 5 enzymes are associated with gastroschisis, a congenital defect in the anterior abdominal wall through which the abdominal organs freely protrude. In these cases, enzyme activities are usually at Ͼ95th percentile, due to the open communication between amniotic fluid and the bowel in that disorder (45 ).…”

Section: Alternative Sample Matrices For Fetal Health Assessmentmentioning

confidence: 99%

Fetal Laboratory Medicine: On the Frontier of Maternal–Fetal Medicine

Geaghan

2012

Clinical Chemistry

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BACKGROUND:Emerging antenatal interventions and care delivery to the fetus require diagnostic support, including laboratory technologies, appropriate methodologies, establishment of special algorithms, and interpretative guidelines for clinical decision-making.CONTENT: Fetal diagnostic and therapeutic interventions vary in invasiveness and are associated with a spectrum of risks and benefits. Fetal laboratory assessments are well served by miniaturized diagnostic methods for blood analysis. Expedited turnaround times are mandatory to support invasive interventions such as cordocentesis and intrauterine transfusions. Healthassociated reference intervals are required for fetal test interpretation. Fetal blood sampling by cordocentesis carries substantial risk and is therefore performed only when fetal health is impaired, or at risk. When the suspected pathology is not confirmed, however, normative fetal data can be collected. Strategies for assurance of sample integrity from cordocenteses and confirmation of fetal origin are described. After birth, definitive assessment of prenatal environmental and/or drug exposures to the fetus can be retrospectively assessed by analysis of meconium, hair, and other alternative matrices. A rapidly advancing technology for fetal assessment is the use of fetal laboratory diagnostic techniques that use cell-free fetal DNA collected from maternal plasma, and genetic analysis based on molecular counting techniques.

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Clinical evaluation of isolated nonvisualized fetal gallbladder

et al. 2007

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Establishment of reference values of five amniotic fluid enzymes. Analytical performances of the Hitachi 911. Application to complicated pregnancies

Cited by 12 publications

References 16 publications

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Fetal Laboratory Medicine: On the Frontier of Maternal–Fetal Medicine

Clinical evaluation of isolated nonvisualized fetal gallbladder

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Establishment of reference values of five amniotic fluid enzymes. Analytical performances of the Hitachi 911. Application to complicated pregnancies

Cited by 12 publications

References 16 publications

Nonvisualization of the Fetal Gallbladder: Can Levels of &#947;-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosis&#947;

Nonvisualization of the Fetal Gallbladder: Can Levels of &#947;-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosis&#947;

Fetal Laboratory Medicine: On the Frontier of Maternal–Fetal Medicine

Clinical evaluation of isolated nonvisualized fetal gallbladder

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ