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Prenatal diagnosis of megacystis microcolon intestinal hypoperistalsis syndrome by biochemical analysis of fetal urine
Author(s) -
Rosenblatt Jonathan,
Dreux Sophie,
Spaggiari Emmanuel,
Morin Cécile,
Allaf Bichr,
Valat Anne Sylvie,
Halim Danny,
Oury JeanFrançois,
Muller Françoise
Publication year - 2018
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.5283
Subject(s) - medicine , urine , fetus , urology , endocrinology , prenatal diagnosis , gastroenterology , pregnancy , biology , genetics
Objectives The objective of the study is to determine a model of fetal urine biochemical markers to differentiate megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) from other megacystis. Method This is a retrospective study of biochemical analysis of fetal urine in patients who presented prenatally with megacystis. We studied β2‐microglobulin, sodium, calcium, and phosphorus. Twenty‐six patients subsequently diagnosed with MMIHS were compared with 2 control groups: one of end‐stage renal failure (64 fetuses) and the second of “good” postnatal renal function (control group, 64 fetuses). Results Mean fetal urine β2‐microglobulin was significantly higher ( P < .001) in end‐stage renal failure (15.7 mg/L) than in MMIHS (2.2 mg/L) and the control group (3.2 mg/L). Fetal urine profiles differed significantly ( P < .001) between MMIHS and the control group: median sodium 46.5 and 51 mmol/L, median calcium 1.12 and 0.73 mmol/L, and median phosphorus 0.03 and 0.15 mmol/L respectively. Fetal urinary ionic index [ratio: calcium / (phosphorus × sodium)] gave an area under the ROC curve of 0.86, at 54% sensitivity and 97% specificity, with correct classification in 84% of cases. We defined a nomogram to obtain a probability for MMIHS. Conclusion Fetal urinalysis can be helpful in prenatal differentiation of MMIHS from posterior urethral valves with good postnatal renal function.