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Carcinoembryonic antigen as a biomarker for meconium‐stained amniotic fluid
Author(s) -
Mor Amir,
Tal Reshef,
Irani Mohamad,
McCalla Sandra,
Haberman Shoshana,
Garg Deepika,
Wajntraub Birgitta
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.07.032
Subject(s) - amniotic fluid , medicine , obstetrics , meconium aspiration syndrome , meconium , urine , biomarker , premature rupture of membranes , carcinoembryonic antigen , gynecology , gestational age , pregnancy , gastroenterology , fetus , chemistry , cancer , biochemistry , genetics , biology
Objective To assess whether elevated carcinoembryonic antigen (CEA) concentration in amniotic fluid can indicate meconium‐stained amniotic fluid (MSAF). Methods In a prospective cohort study, women with a term singleton pregnancy who were in labor but had intact membranes were recruited at a center in Israel over a 5‐month period in 2013. Only women who subsequently underwent artificial rupture of membranes following a clear medical indication were included. Samples of amniotic fluid, urine, and serum were collected. Amniotic fluid was examined by sight and classified as clear, MSAF, or undetermined. CEA concentration in the samples was measured. Results Among 81 participants, 45 had clear amniotic fluid, 28 had MSAF, and eight had undetermined amniotic fluid. Mean CEA concentration was more than 10 times higher in MSAF (2658 μg/L, standard error 250) than in clear amniotic fluid (238 μg/L, standard error 29; P < 0.001). Receiver operating characteristic curve analysis demonstrated a sensitivity of 96% and a specificity of 100% for distinguishing MSAF from clear amniotic fluid at a CEA cutoff of 799.2 μg/L. CEA concentrations in urine and serum were all within the normal range (≤ 5 μg/L), irrespective of amniotic fluid status. Conclusion High CEA concentrations in amniotic fluid can assist in the diagnosis of MSAF. These findings could provide the basis for a bedside test to detect MSAF following rupture of membranes.