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Deceased co-twin as a cause of false positive amniotic fluid AFP and AChE
Authors:Dr Elizabeth J T Winsor  B St John Brown  Edwin R Luther  Stephen A Heifetz  J Philip Welch
Institution:Departments of Pediatrics. Radiology, Obstetrics and Gynecology, and Pathology, Dalhousie University. Halifax, N.S. Canada

Atlantic Research Centre for Mental Retardation and Grace Maternity Hospital, Halifax. N.S. Canada

Abstract:A pregnancy was terminated because of persistently elevated amniotic fluid AFP (+10 S.D.) and an AChE band of low intensity on gel electrophoresis. No fetal anomalies were detected by ultrasonographic examination. Autopsy revealed an apparently normal fetus of about 20 weeks gestation. Attached to the placenta was a small sac containing a fetus papyraceus co-twin of about 8–9 weeks gestation. The small deceased co-twin and its gestational sac were not detected prenatally despite multiple ultrasonographic examinations. The difficulty in the interpretation of apparently conflicting results is emphasized.
Keywords:AFP  AChE  Fetus papyraceus  Deceased co-twin
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