Abstract
Objective:Fetal hydronephrosis (FH) is the most common fetal renal pathology encountered in daily obstetric practice. Urinary and serum carbohydrate antigen 19-9 (CA 19-9) concentrations are elevated in obstructive renal pathologies. Our aim was to assess maternal urinary and serum CA 19-9 concentrations in pregnancies with FH and compare results with controls.Material and Methods:Twenty pregnancies with severe FH, 20 pregnancies with mild-moderate FH, and 20 healthy singleton pregnancies were included in this descriptive, case-control study. The diagnosis and classification of FH was based on the anterioposterior diameter of fetal renal pelvis. Maternal urinary and serum CA 19-9 concentrations were measured and compared between groups.Results:Severe FH cases had significantly higher maternal urinary CA 19-9 concentrations compared to controls (median: 75 vs 24 U/mL; respectively; p=0.014). Concentrations of CA 19-9 did not differ between the mild-moderate FH group and control group. No statistically significant difference was found between the groups with respect to maternal serum CA 19-9 concentrations.Conclusion:Our results show that maternal urinary CA 19-9 concentration is significantly higher in pregnancies with severe FH. However, no difference was detected in serum CA 19-9 concentrations between pregnancies with severe FH, mild-moderate FH and controls. If the mechanisms of transplacental passage and maternal urinary excretion are clarified, maternal urinary CA 19-9 may be a potential marker for indicating fetal kidney damage.
Highlights
Fetal renal pathologies are frequently encountered in obstetric practice
No statistically significant difference was found for maternal serum Carbohydrate antigen 19-9 (CA 19-9) concentrations between the groups (p=0.353)
Post-hoc Dunn’s analysis revealed urinary CA 19-9 concentrations were statistically significantly higher in the severe Fetal hydronephrosis (FH) group compared to the control group
Summary
Fetal renal pathologies are frequently encountered in obstetric practice. Fetal hydronephrosis (FH) is the most common antenatally detected renal pathology [1]. The most basic and frequently used technique for evaluation of the fetal renal pelvis is the imaging-based measurement from anterior to posterior in the transverse plane. This measurement depends on the operator and is affected by maternal hydration. It does not provide information about renal parenchymal damage [2,3]. Carbohydrate antigen 19-9 (CA 19-9) is a Lewis blood group antigen derivative glycoprotein [5] This antigen is found in the amniotic fluid in high concentrations due to the secretion of amnion and decidual cells [6].
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