title: Amniotic fluid biochemistry in isolated polyhydramnios: a series of 464 cases.
abstract: OBJECTIVE
  To report amniotic fluid biochemistry in a large series of 464 cases of isolated polyhydramnios in order to analyze both the outcome and the benefit of amniotic fluid biochemistry.
  
  
  METHODS
  This retrospective cohort (2008-2012) included polyhydramnios cases for which amniotic fluid samples were sent to our laboratory for biochemical analysis (total protein, alpha-fetoprotein and gamma-glutamyl transpeptidase) so as to investigate the etiology. A Bartter index and an esophageal atresia index were defined. Final diagnoses were compared between groups to determine the association between these indices and the frequency and type of adverse outcomes.
  
  
  RESULTS
  Among 464 cases of polyhydramnios considered isolated at ultrasound examination, severe fetal diseases were diagnosed in 136 (29.3%): 46 (9.9%) chromosomal anomalies, 28 (6%) Bartter syndrome, 23 (4.95%) other genetic syndromes, 22 (4.75%) swallowing disorders and 17 (3.7%) uro-nephrological disorders. Amniotic fluid biochemistry identified esophageal atresia with 66.6% (10/15) sensitivity and 100% specificity and Bartter syndrome with 85.7% (24/28) sensitivity and 84.2% specificity.
  
  
  CONCLUSIONS
  Isolated polyhydramnios is associated with a high risk of severe fetal diseases. Molecular cytogenetics and amniotic fluid biochemistry are helpful tools.
authors.affiliation: Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France.
authors.forename: Bichr
authors.initials: B
authors.lastname: Allaf
authors.affiliation: Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Dreux
authors.affiliation: Gynécologie-Obstétrique, Hôpital Robert Debré, APHP, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz
authors.affiliation: Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Czerkiewicz
authors.affiliation: Gynécologie-Obstétrique CHU Nantes, Nantes, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Le Vaillant
authors.affiliation: Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
authors.affiliation: Pôle Femme Mère Nouveau Né, Clinique d'Obstétrique, CHRU Lille, Lille, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Houfflin-Debarge
authors.affiliation: Gynécologie-Obstétrique CHU Poitiers, Poitiers, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Maréchaud
authors.affiliation: Gynécologie-Obstétrique, Hôpital Robert Debré, APHP, Paris, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Oury
authors.affiliation: Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France.|Université Versailles Saint Quentin en Yvelines, Versailles, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Muller
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism*; D025063:Chromosome Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D006831:Polyhydramnios / Q000235:genetics / Q000378:metabolism*; D011247:Pregnancy