Amniotic fluid inflammatory proteins and digestive compounds profile in fetuses with gastroschisis undergoing amnioexchange.
OBJECTIVE
In gastroschisis, an inflammatory process related to the presence of digestive compounds may be involved in intestinal damage. We measured the amniotic fluid concentrations of total protein, ferritin and amylase, lipase, gamma-glutamyl transferase and bile acids before each amnioexchange performed in women whose infants had gastroschisis. We estimated the correlation among total proteins, ferritin and digestive compounds and postnatal outcome.


METHODS
All women whose infants had gastroschisis in our fetal medicine unit are offered repeated amnioexchange during the third trimester of pregnancy to improve the quality of the exteriorised bowel at birth. Amniotic fluid was sampled at the beginning of each amnioexchange and total proteins, ferritin and digestive compounds were assayed.


METHODS
This study was conducted in the Department of Perinatology of the University Hospital Robert Debré in Paris.


METHODS
Thirty pregnant women with a gastroschisis affected fetus diagnosed antenatally.


METHODS
The biological results were expressed as multiples of the median with respect to a control population.


METHODS
Gestational age at delivery and the outcome of the infants were recorded and correlated with amniotic fluid total proteins, ferritin and digestive compounds.


RESULTS
There was a positive correlation (P < 0.01) between digestive compounds (except amylase at the final amnioexchange) and ferritin on the one hand, and all digestive compounds and total proteins concentration at the final amnioexchange on the other. In addition, among total proteins amylase and lipase, lipase concentrations were related with parameters of short term outcome (P < 0.05).


CONCLUSIONS
Amniotic total proteins and ferritin are elevated in fetuses presenting with gastroschisis as a consequence of an inflammatory process. Inflammation may be induced by the presence of digestive compounds in the amniotic fluid. The concentrations of which may constitute a marker of short term outcome of the newborn infant.
Department of Perinatology, Hôpital Robert Debré, Paris, France.
Laurence
L
Burc
Jean-Luc
JL
Volumenie
Pascal
P
de Lagausie
Jean
J
Guibourdenche
Jean-François
JF
Oury
Edith
E
Vuillard
Olivier
O
Sibony
Philippe
P
Blot
Carole
C
Saizou
Dominique
D
Luton
D000293:Adolescent; D000328:Adult; D000650:Amnion; D000653:Amniotic Fluid / Q000737:chemistry*; D000681:Amylases / Q000032:analysis; D001647:Bile Acids and Salts / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D004322:Drainage / Q000379:methods; D005260:Female; D005293:Ferritins / Q000032:analysis; D020139:Gastroschisis / Q000175:diagnosis* / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D007621:Karyotyping; D008049:Lipase / Q000032:analysis; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D011379:Prognosis; D012965:Sodium Chloride / Q000008:administration & dosage; D005723:gamma-Glutamyltransferase / Q000032:analysis
D001647:Bile Acids and Salts; D015415:Biomarkers; D012965:Sodium Chloride; D005293:Ferritins; D005723:gamma-Glutamyltransferase; D008049:Lipase; D000681:Amylases