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Amniotic fluid digestive enzymes: Diagnostic value in fetal gastrointestinal obstructions
Author(s) -
Muller Françoise,
Dommergues Marc,
Ville Yves,
Lewin Fanny,
DelvalezMorichon Nicole,
NihoulFekete Claire,
Bargy Fréderic,
Dumez Yves,
Boue André
Publication year - 1994
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1970141013
Subject(s) - amniotic fluid , amniocentesis , medicine , duodenal atresia , gastroenterology , prenatal diagnosis , fetus , gastrointestinal tract , alkaline phosphatase , polyhydramnios , pathology , atresia , pregnancy , biology , enzyme , biochemistry , genetics
The diagnostic value of amniotic fluid gamma‐glutamyl‐transpeptidase (GGTP) and intestinal alkaline phos‐phatase (iALP) was evaluated in 55 patients who underwent amniocentesis for karyotyping because fetal gastric or small bowel dilatation had been detected by ultrasound. Gastrointestinal malformation was confirmed in 46 cases and there was no gastrointestinal anomaly in nine cases. Prenatal ultrasound was suggestive of gastroduodenal dilatation in 34 cases (group I) and small bowel dilatation in 21 cases (group II). In group I, amniotic fluid GGTP above the 99th percentile was 71 per cent sensitive and 100 per cent specific for a true anatomical defect of the digestive tract (mainly duodenal atresia). In group II, high levels of GGTP and/or iALP were 69 per cent sensitive and 83 per cent specific for a fetal digestive tract anomaly. In other words, when digestive tract dilatations were diagnosed by prenatal sonography, abnormal amniotic fluid enzyme activities were strongly suggestive of such an anomaly, the possibility of which was not precluded by normal amniotic fluid iALP and GGTP activities. But amniotic fluid digestive enzyme activities do not help in defining the prognosis.