Persistently elevated AFP and AChE in amniotic fluid from a normal fetus following demise of its twin |
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| Authors: | Harold N. Bass Joan B. Oliver Murali Srinivasan Ruth Petrucha Won Ng Jo Ellen S. Lee |
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| Affiliation: | 1. Departments of Pediatrics (Genetic Services) and Obstetrics and Gynecology, Kaiser Permanente Medical Center, Panorama City, California 91402, U.S.A.;2. Department of Obstetrics and Gynecology (Maternal and Fetal Medicine), Kaiser Permanente Medical Center, Los Angeles, California 90027, U.S.A.;3. Biochemistry Laboratory, Division of Medical Genetics, Childrens Hospital of Los Angeles, Los Angeles, California 90027, U.S.A. |
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| Abstract: | Intrauterine fetal demise (IUFD) in one of twins at 12 weeks of gestation was accompanied by markedly elevated maternal serum alpha-fetoprotein (AFP) at 17 and 18 weeks. Amniotic fluid AFP from the healthy surviving twin's sac at 18·5 and 23 weeks was also greatly increased along with a positive acetylcholinesterase (AChE) band. Persistently elevated AFP and positive AChE so long after fetal demise–-6·5 and 11 weeks post IUFD–-has not, to our knowledge, been previously described. In similar cases, high level ultrasound and careful placental examination at birth should be utilized to search for fetal abnormalities or multiple pregnancy with IUFD. |
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| Keywords: | Multiple pregnancy Fetal demise Alpha-fetoprotein Acetylcholinesterase Ultrasonography |
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