Burc Laurence, Volumenie Jean-Luc, de Lagausie Pascal, Guibourdenche Jean, Oury Jean-François, Vuillard Edith, Sibony Olivier, Blot Philippe, Saizou Carole, Luton Dominique
Department of Perinatology, Hôpital Robert Debré, Paris, France.
BJOG. 2004 Apr;111(4):292-7. doi: 10.1111/j.1471-0528.2004.00070.x.
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.
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.
This study was conducted in the Department of Perinatology of the University Hospital Robert Debré in Paris.
Thirty pregnant women with a gastroschisis affected fetus diagnosed antenatally.
The biological results were expressed as multiples of the median with respect to a control population.
Gestational age at delivery and the outcome of the infants were recorded and correlated with amniotic fluid total proteins, ferritin and digestive compounds.
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).
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.
在腹裂中，与消化性化合物存在相关的炎症过程可能参与肠道损伤。我们测量了在其婴儿患有腹裂的女性每次进行羊膜腔穿刺换液前羊水总蛋白、铁蛋白、淀粉酶、脂肪酶、γ-谷氨酰转移酶和胆汁酸的浓度。我们估计了总蛋白、铁蛋白与消化性化合物之间的相关性以及产后结局。
我们胎儿医学科所有其婴儿患有腹裂的女性在妊娠晚期均接受重复羊膜腔穿刺换液，以改善出生时外露肠管的质量。在每次羊膜腔穿刺换液开始时采集羊水样本，并检测总蛋白、铁蛋白和消化性化合物。
本研究在巴黎罗伯特·德布雷大学医院围产医学科进行。
30名产前诊断为胎儿患有腹裂的孕妇。
生物学结果以相对于对照人群中位数的倍数表示。
记录分娩时的孕周及婴儿结局，并将其与羊水总蛋白、铁蛋白和消化性化合物进行相关性分析。
一方面，消化性化合物（末次羊膜腔穿刺换液时的淀粉酶除外）与铁蛋白之间存在正相关（P<0.01），另一方面，所有消化性化合物与末次羊膜腔穿刺换液时的总蛋白浓度之间也存在正相关。此外，在总蛋白、淀粉酶和脂肪酶中，脂肪酶浓度与短期结局参数相关（P<0.05）。
由于炎症过程，患有腹裂的胎儿羊水中总蛋白和铁蛋白升高。炎症可能由羊水中消化性化合物的存在所诱导。其浓度可能构成新生儿短期结局指标。
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