Determination of bile acid concentration in human amniotic fluid for prenatal diagnosis of intestinal obstruction

• Published in: Pediatrics (Evanston) Vol. 59; no. 5; pp. 647 - 650
• Main Authors: Délèze, G, Sidiropoulos, D, Paumgartner, G
• Format: Journal Article
• Language: English
• Published: United States 01-05-1977
• Subjects: Amniotic Fluid - analysis; Bile Acids and Salts - analysis; Female; Fetal Diseases - diagnosis; Fetus; Gestational Age; Humans; Intestinal Obstruction - diagnosis; Pregnancy; Prenatal Diagnosis
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.59.5.647

Bile acid concentration was measured in amniotic fluid obtained for standard indications from 11 healthy pregnant women without polyhydramnios (28 to 42 weeks of gestation) and from 9 patients with polyhydramnios (28 to 38 weeks of gestation). Two of the latter women delivered infants with intestinal obstruction distal to the papilla of Vater, a condition that causes regurgitation of bile into the amniotic fluid. In the women without polyhydramios, the total bile acid concentration ranged from 1.4 to 2.4 micronmol/liter. In the seven patients with polyhydramnios not associated with fetal intestinal obstruction, the bile acid concentration in amniotic fluid was not significantly different (0.9 to 1.9 micronmol/liter). By contrast, the bile acid concentration in amniotic fluid specimens from the two patients with polyhydramnios who gave birth to children with intestinal obstruction was considerably elevated (30.3 to 83.1 micronmol/liter). These findings suggest that determination of bile acid concentration in amniotic fluid permits prenatal diagnosis of intestinal obstruction distal to the papilla of Vater.