Prognostic significance of maternal urinary carbohydrate antigen 19-9 for antenatal diagnosis of posterior urethral valve associated with fetal hydronephrosis
- 25 Downloads
To evaluate the predictive role of maternal urinary CA 19-9 as a non-invasive marker for diagnosing antenatal posterior urethral valve (PUV).
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.
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).
This is the first time that maternal urinary CA 19-9 has been applied as a noninvasive and practical diagnostic marker in antenatal PUV.
KeywordsPrenatal diagnosis Hydronephrosis Biomarkers Urine CA 19-9 antigen
Anteroposterior renal pelvic diameter
- CA 19-9
Society for Fetal Urology
None of the authors has direct or indirect commercial financial incentive associating with publishing the article.
Compliance with ethical standards
Conflict of interest
None of the authors has direct or indirect commercial financial incentive associated with publishing the article and does not have any conflict of interest, and will sign the Disclosing Form.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 3.Sarhan O, Zaccaria I, Macher MA, Muller F, Vuillard E, Delezoide AL, Sebag G, Oury JF, Aigrain Y, El-Ghoneimi A (2008) Long-term outcome of prenatally detected posterior urethral valves: single center study of 65 cases managed by primary valve ablation. J Urol 179(1):307–312. https://doi.org/10.1016/j.juro.2007.08.160 (discussion 312–303) CrossRefGoogle Scholar
- 11.Bhadoo D, Bajpai M, Abid A, Sukanya G, Agarwala S, Srinivas M, Deka D, Agarwal N, Agarwal R, Kumar R (2015) Study of prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. J Indian Assoc Pediatr Surg 20(2):63–67. https://doi.org/10.4103/0971-9261.151546 CrossRefGoogle Scholar
- 16.Assadi F, Schloemer N (2012) Simplified diagnostic algorithm for evaluation of neonates with prenatally detected hydronephrosis. Iran J Kidney Dis 6(4):284Google Scholar
- 19.Rickard M, Easterbrook B, Kim S, Farrokhyar F, Stein N, Arora S, Belostotsky V, DeMaria J, Lorenzo AJ, Braga LH (2017) Six of one, half a dozen of the other: a measure of multidisciplinary inter/intra-rater reliability of the society for fetal urology and urinary tract dilation grading systems for hydronephrosis. J Pediatr Urol 13(1):80 e81–80 e85. https://doi.org/10.1016/j.jpurol.2016.09.005 CrossRefGoogle Scholar
- 22.Khorramirouz R, Ebadi M, Rahimi Sherbaf F, Kajbafzadeh A-M (2014) Persistent high level of urinary tumor marker carbohydrate antigen 19–9 in prenatally diagnosed dysplastic kidney. Case Rep Urol 2014:259870Google Scholar
- 24.Suzuki K (2000) Renal pelvic and ureteral cancer with extremely high serum level of carbohydrate antigen 19-9 (CA 19-9): a case report. Nishi Nihon J Urol 62(12):659–663Google Scholar
- 27.Kutlu O, Celik O, Koksal I, Yigit S, Danisman A (2012) Serum carbohydrate antigen 19-9 levels in patients with unilateral hydronephrosis due to urinary lithiasis. Minerva Urol Nefrol 64(3):217–221Google Scholar
- 28.Muller F, Dommergues M, Mandelbrot L, Aubry M-C, Nihoul-Fekete C, Dumez Y (1993) Fetal urinary biochemistry predicts postnatal renal function in children with bilateral obstructive uropathies. Obstetr Gynecol 82(5):813–820Google Scholar