Relationship of non‐visualization of the fetal gallbladder and amniotic fluid digestive enzymes analysis to outcome

Dreux, Sophie; Boughanim, Mathias; Lépinard, Catherine; Guichet, Agnès; Rival, Jean-Marie; Becdelièvre, Alix de; Duguépéroux, I.; Müller, Françoise

doi:10.1002/pd.3830

Cited by 25 publications

(46 citation statements)

References 21 publications

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“…The sensitivity and specificity of abnormal GGTP in predicting serious morbidity in fetuses whose gallbladder was not visualized was 80 and 96%, respectively. These findings concur with those of Dreux et al [6] who concluded that prior to 22 weeks of gestation, an abnormal pattern of amniotic fluid digestive enzymes had 90% sensitivity and 80% specificity in detecting CF or BA; however, after 22 weeks, the sensitivity dropped to 53%. In contrast, Shen et al [7] concluded that testing digestive enzymes in amniotic fluid is not justified for assessing cases of isolated NVFGB.…”

Section: Discussionsupporting

confidence: 56%

“…Amniotic fluid digestive enzymes are considered by some as a valuable prenatal tool to assess the fetal bile apparatus [6,12,14,18]. …”

Section: Discussionmentioning

confidence: 99%

“…However, controversy exists regarding the yield of assessing GGTP levels of amniotic fluid in the prenatal diagnosis of fetuses whose gallbladder cannot be visualized [6,7,18,19,20]. This is mainly due to the rarity of BA, with a reported incidence of 1:20,000 live births [9], and the scarcity of reports on the prenatal diagnosis of BA.…”

Section: Introductionmentioning

confidence: 97%

“…The fetal gallbladder size increases during pregnancy, reaching a plateau at around 30 weeks [4,5]. In the majority of cases, in which the fetal gallbladder is not visualized on the early scan (0.1% of pregnancies), it is subsequently detected either later in pregnancy or after delivery by an ultrasound evaluation [1,2,6,7]. …”

Section: Introductionmentioning

confidence: 99%

“…Abnormal levels of amniotic fluid enzymes have been used for the prenatal diagnosis of digestive tract anomalies, as in CF, intestinal obstruction, and BA [6,12,13,17]. However, controversy exists regarding the yield of assessing GGTP levels of amniotic fluid in the prenatal diagnosis of fetuses whose gallbladder cannot be visualized [6,7,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Bardin¹,

Ashwal‏²,

Davidov³

et al. 2015

Fetal Diagn Ther

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Objective: In cases of nonvisualization of the fetal gallbladder (NVFGB), we investigated whether amniotic fluid levels of γ-glutamyl transpeptidase (GGTP) can distinguish normal development or benign gallbladder agenesis from severe anomaly such as biliary atresia. Methods: This is a retrospective cohort study of pregnancies in which the gallbladder was not visualized in the second-trimester fetal anatomy scan. Levels of GGTP in amniotic fluid were analyzed prior to 22 weeks of gestation by amniocentesis. Data were collected regarding other fetal malformations, fetal karyotype, and screening results for cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations. Results: Of 32 cases of NVFGB, 27 (84%) had normal GGTP levels and a normal CFTR gene screening, and 1 of them had an abnormal karyotype. Three of the 5 cases with low GGTP were diagnosed with extrahepatic biliary atresia, proven by histopathological examination following termination of pregnancy. The fourth case had hepatic vasculature abnormality and the fifth isolated gallbladder agenesis. In 22 of 32 cases (68.7%), the gallbladder was detected either later in pregnancy or after delivery. Conclusion: The findings support low levels of GGTP in amniotic fluid, combined with NVFGB, as a sign of severe disease, mainly biliary atresia. Normal GGTP levels, concomitant with isolated NVFGB, carry a good prognosis.

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Section: Discussionsupporting

confidence: 56%

“…Amniotic fluid digestive enzymes are considered by some as a valuable prenatal tool to assess the fetal bile apparatus [6,12,14,18]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Bardin¹,

Ashwal‏²,

Davidov³

et al. 2015

Fetal Diagn Ther

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Prenatal sonographic diagnosis of biliary tract malformations

Koukoura

Kelesidou

Delianidou

et al. 2019

J of Clinical Ultrasound

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Congenital anomalies of the biliary tract include a variety of pathologic conditions, such as biliary atresia, choledochal cysts, gallbladder agenesis, congenital cholelithiasis, and gallbladder duplication. Although most of these malformations are rare and benign conditions, they may occasionally represent a major threat to extrauterine life. Visualization of a normal‐sized gallbladder should be a mandatory component of the second‐trimester anomaly ultrasound scan. Advances in prenatal sonography enable the detection of biliary tract congenital malformations. In this review, we discuss the detection rates, sonographic features, and prognosis of the most frequently prenatally diagnosed biliary tract malformations.

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Improving prenatal detection of abdominal supraumbilical anomalies: The sonographic examination of fetal anechoic spaces of upper abdomen revisited

Sepúlveda¹,

Wong²,

Ranzini

2023

J of Clinical Ultrasound

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Visualization of the axial plane of the fetal abdomen is mandatory to obtain abdominal biometry in the assessment of fetal growth in the second and third trimesters.The main anatomic landmarks that must be identified in this view include the fetal stomach and the intrahepatic portion of the umbilical vein, which are easily identifiable as they appear anechoic on ultrasound. The gallbladder is the other prominent anechoic structure in this plane. Focused study of the morphological characteristics of, and spatial relationship among, these three anechoic spaces is a simple technique to detect anomalies involving fetal upper abdominal organs. In this review, the sonographic features of those conditions that can be detected using this technique, which was termed the Fetal Examination of the Anechoic Spaces of upper abdomen Technique (FEAST), are classified and illustrated.

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Relationship of non‐visualization of the fetal gallbladder and amniotic fluid digestive enzymes analysis to outcome

Abstract: Non-visualization of the fetal gallbladder was associated with severe anomalies in 24% of cases. Prior to 22 weeks, determination of AF-DE contributes to the prediction of biliary atresia or the presence of cystic fibrosis.

Cited by 25 publications

References 21 publications

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Prenatal sonographic diagnosis of biliary tract malformations

Improving prenatal detection of abdominal supraumbilical anomalies: The sonographic examination of fetal anechoic spaces of upper abdomen revisited

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Relationship of non‐visualization of the fetal gallbladder and amniotic fluid digestive enzymes analysis to outcome

Abstract: Non-visualization of the fetal gallbladder was associated with severe anomalies in 24% of cases. Prior to 22 weeks, determination of AF-DE contributes to the prediction of biliary atresia or the presence of cystic fibrosis.

Cited by 25 publications

References 21 publications

Nonvisualization of the Fetal Gallbladder: Can Levels of &#947;-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosis&#947;

Nonvisualization of the Fetal Gallbladder: Can Levels of &#947;-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosis&#947;

Prenatal sonographic diagnosis of biliary tract malformations

Improving prenatal detection of abdominal supraumbilical anomalies: The sonographic examination of fetal anechoic spaces of upper abdomen revisited

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Resources

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ