title: Biochemical analysis of cystic fluid in the diagnosis of fetal intra-abdominal masses.
abstract: OBJECTIVE
  The aim of the study was to evaluate a biochemical analysis of fluid sampled in utero from fetal abdominal cystic masses.
  
  
  METHODS
  A retrospective study of 42 intra-abdominal cystic masses [ovarian cysts (n = 22), cloaca (n = 8), urodigestive fistulae (n = 4), and urogenital sinuses (n = 8)] was carried out. The control group (n = 30) consisted of fetal urine. Seven biochemical markers were assayed: sodium, estradiol, β(2) -microglobulin, total proteins and digestive enzymes, gamma-glutamyl transpeptidase, aminopeptidase M, and intestinal alkaline phosphatase isoenzyme. Outcome of pregnancies and final diagnosis of intra-abdominal mass were known in all cases.
  
  
  RESULTS
  Biochemical patterns allowed to demonstrate (1) an ovarian origin based on elevated level of estradiol and of total proteins (100% specificity, 100% sensitivity); (2) urodigestive fistula based on the presence of high levels of digestive enzymes (cloaca in female fetuses or recto-urethral fistula in male fetuses); and (3) a renal origin (urinary pattern with low total proteins and absence of digestive enzymes); however, a biochemical pattern could not differentiate between fetal urogenital sinus and megacystis.
  
  
  CONCLUSIONS
  Etiological diagnosis of a fetal cystic abdominal mass could impact both prenatal and postnatal management providing adapted prenatal counseling by a pediatric surgeon in surgically correctable congenital anomalies.
authors.affiliation: Gynécologie Obstétrique, Hôpital Robert Debré, AP-HP, Université Paris-Diderot, Paris, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Lecarpentier
authors.forename: Sophie
authors.initials: S
authors.lastname: Dreux
authors.forename: Thomas
authors.initials: T
authors.lastname: Blanc
authors.forename: Bruno
authors.initials: B
authors.lastname: Schaub
authors.forename: Yves
authors.initials: Y
authors.lastname: Ville
authors.forename: Laurent
authors.initials: L
authors.lastname: Mandelbrot
authors.forename: Alaa
authors.initials: A
authors.lastname: El Ghoneimi
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Oury
authors.forename: Françoise
authors.initials: F
authors.lastname: Muller
mesh_terms: D000469:Alkaline Phosphatase / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D018826:CD13 Antigens / Q000032:analysis; D016022:Case-Control Studies; D020420:Cyst Fluid / Q000737:chemistry*; D016154:Digestive System Fistula / Q000175:diagnosis*; D004958:Estradiol / Q000032:analysis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005333:Fetus / Q000737:chemistry*; D058851:GPI-Linked Proteins / Q000032:analysis; D006801:Humans; D008297:Male; D010048:Ovarian Cysts / Q000175:diagnosis*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012964:Sodium / Q000032:analysis; D014548:Urinary Fistula / Q000175:diagnosis*; D014556:Urine / Q000737:chemistry; D001613:beta 2-Microglobulin / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000032:analysis
chemical_list: D015415:Biomarkers; D058851:GPI-Linked Proteins; D001613:beta 2-Microglobulin; D004958:Estradiol; D012964:Sodium; D005723:gamma-Glutamyltransferase; C063088:ALPI protein, human; D000469:Alkaline Phosphatase; D018826:CD13 Antigens