AI Article Synopsis
- The study investigates the use of amniotic fluid gamma-glutamyl transferase (AFGGT) levels to identify biliary atresia (BA) in cases where the fetal gallbladder isn't visible.
- The research involved validating a new GGT assay for amniotic fluid and establishing a gestational age-specific reference range to assess its predictive value for BA.
- Results showed that while a low AFGGT level (<2.5th percentile) suggests the need for further investigation, it does not definitively indicate BA, whereas AFGGT levels ≥2.5th percentile are likely to rule out the condition.
Article Abstract
Introduction: The level of amniotic fluid gamma-glutamyl transferase (AFGGT) may help identify biliary atresia (BA) in cases of non-visualisation of the fetal gallbladder (NVFGB). This study aimed to validate a serum/plasma matrix-based gamma-glutamyl transferase (GGT) assay for amniotic fluid (AF) samples, establish a local gestational age-specific AFGGT reference range, and evaluate the efficacy of AFGGT for predicting fetal BA in pregnancies with NVFGB using the constructed reference range.
Methods: The analytical performance of a serum/plasma matrix-based GGT assay on AF samples was evaluated using a Cobas c502 analyser. Amniotic fluid gamma-glutamyl transferase levels in confirmed euploid singleton pregnancies (16 to 22 weeks of gestation) were determined using the same analyser to establish a local gestational age-specific reference range (the 2.5th to 97.5th percentiles). This local reference range was used to determine the positive predictive value (PPV) and negative predictive value (NPV) of AFGGT level <2.5th percentile for identifying fetal BA in euploid pregnancies with NVFGB.
Results: The serum/plasma matrix-based GGT assay was able to reliably and accurately determine GGT levels in AF samples. Using the constructed local gestational age-specific AFGGT reference range, the NPV and PPV of AFGGT level <2.5th percentile for predicting fetal BA in pregnancies with NVFGB were 100% and 25% (95% confidence interval=0, 53), respectively.
Conclusion: In pregnancies with NVFGB, AFGGT level ≥2.5th percentile likely excludes fetal BA. Although AFGGT level <2.5th percentile is not diagnostic of fetal BA, fetuses with AFGGT below this level should be referred for early postnatal investigation.
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| http://dx.doi.org/10.12809/hkmj2210567 | DOI Listing |
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