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Prenatal diagnosis of megacystis-microcolon-intestinal hypoperistalsis syndrome: contribution of amniotic fluid digestive enzyme assay and fetal urinalysis.
[megacystis-microcolon-intestinal hypoperistalsis syndrome]
Megacystis-
microcolon
-
intestinal
hypoperistalsis
syndrome
(
MMIHS
)
is
a
usually
lethal
disease
during
the
first
year
of
life
.
There
is
no
specific
ultrasound
prenatal
diagnosis
and
no
identified
genetic
locus
.
The
value
of
amniotic
fluid
digestive
enzyme
assay
and
fetal
urine
biochemistry
in
the
prediction
of
MMIHS
was
analysed
.
Retrospective
study
of
14
MMIHS
cases
.
Amniotic
fluid
digestive
enzymes
and
fetal
urine
biochemistry
were
compared
in
MMIHS
and
megabladder
(
63
and
264
cases
respectively
)
.
Abnormal
amniotic
fluid
digestive
enzyme
profile
(
vomiting
of
bile
or
digestive
secretion
leakage
)
was
observed
in
8
/
10
MMIHS
cases
.
These
profiles
were
observed
in
7
/
63
controls
;
80
%
sensitivity
(
95
%
CI
=
55
%
-
100
%
)
;
89
%
specificity
(
95
%
CI
=
81
%
-
96
%
)
.
Fetal
urinalysis
was
normal
in
12
/
12
MMIHS
cases
except
high
calcium
(
>
0
.
6
mmol
/
l
)
.
This
profile
was
observed
in
33
/
264
megabladder
control
cases
;
100
%
sensitivity
;
98
.
7
%
specificity
(
95
%
CI
=
83
.
5
%
-
91
.
5
%
)
.
For
the
first
time
,
we
propose
a
prenatal
diagnosis
of
MMIHS
based
on
amniotic
fluid
digestive
enzyme
assay
and
on
fetal
urinalysis
.
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