title: Carcinoembryonic antigen as a biomarker for meconium-stained amniotic fluid.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA. Electronic address: morami12@gmail.com.
authors.forename: Amir
authors.initials: A
authors.lastname: Mor
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Reshef
authors.initials: R
authors.lastname: Tal
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Irani
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: McCalla
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Haberman
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Deepika
authors.initials: D
authors.lastname: Garg
authors.affiliation: Department of Obstetrics and Gynecology, Laniado Medical Center, Netanya, Israel.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Wajntraub
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D001034:Apgar Score; D015415:Biomarkers / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D008470:Meconium; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D047929:Term Birth; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002272:Carcinoembryonic Antigen
keywords: Carcinoembryonic antigen; Cutoff; Detection; Meconium-stained amniotic fluid; Rupture of membranes