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Prognostic significance of maternal urinary carbohydrate antigen 19-9 for antenatal diagnosis of posterior urethral valve associated with fetal hydronephrosis

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the predictive role of maternal urinary CA 19-9 as a non-invasive marker for diagnosing antenatal posterior urethral valve (PUV).

Methods

A total of 40 women in the third pregnancy trimester were enrolled. Case group (group A) consisted of 20 women with a diagnosis of antenatal PUV. Twenty women with similar gestational age, fetal sex, normal US, and no history of congenital anomalies were chosen as a control group (group B). Maternal urine samples were collected and urinary CA 19-9 was measured in both groups. The correlations between maternal urinary CA 19-9 and APD (measured during pregnancy and the initial evaluation of the newborn) were assessed. CA 19-9 level in first urine of neonates was also evaluated.

Results

The mean ± SD of maternal urine CA 19-9 was higher in PUV group compared to the control group (131.6 ± 23.8 vs. 13 ± 2.7 U/mL). In addition, there was a significant correlation between maternal urinary CA 19-9 and the APD measured at the third trimester (p < 0.001) and the initial evaluation of fetus after birth according to SFU grading system (p < 0.001). However, no significant difference was found between gestational age and urinary CA 19-9 level (p = 0.34). There was also a significant correlation between the CA 19-9 level in first urine of neonates and CA 19-9 level of maternal urine (p < 0.001).

Conclusions

This is the first time that maternal urinary CA 19-9 has been applied as a noninvasive and practical diagnostic marker in antenatal PUV.

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Abbreviations

ANH:

Antenatal hydronephrosis

APD:

Anteroposterior renal pelvic diameter

CA 19-9:

Carbohydrate antigen

SFU:

Society for Fetal Urology

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Funding

None of the authors has direct or indirect commercial financial incentive associating with publishing the article.

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Authors and Affiliations

  1. Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Abdol-Mohammad Kajbafzadeh, Shabnam Sabetkish & Nastaran Sabetkish

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  1. Abdol-Mohammad Kajbafzadeh
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  2. Shabnam Sabetkish
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  3. Nastaran Sabetkish
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Correspondence to Abdol-Mohammad Kajbafzadeh.

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Appendix: SFU grading description

Appendix: SFU grading description

Grade

Description

Grade 0

No dilatation of the renal pelvis

Grade I

Mild dilatation of the renal pelvis (without dilatation of the calyces)

Grade II

Mild dilatation of the renal pelvis and calyces without parenchymal atrophy

Grade III

Moderate dilatation of the renal pelvis and calyces with mild cortical thinning

Grade IV

Gross dilatation of the renal pelvis and calyces plus thinning of the renal parenchyma

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Kajbafzadeh, AM., Sabetkish, S. & Sabetkish, N. Prognostic significance of maternal urinary carbohydrate antigen 19-9 for antenatal diagnosis of posterior urethral valve associated with fetal hydronephrosis. Int Urol Nephrol 51, 909–915 (2019). https://doi.org/10.1007/s11255-019-02138-w

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