Alpha fetoprotein in maternal serum: A new marker for detection of fetal distress and intrauterine death

Abstract

Increase in circulating maternal alpha fetoprotein (AFP) is associated with intrauterine fetal death. The AFP levels in 13 women whose fetuses died in utero were from 280 to 9,000 ng. per milliliter. Nine of them (70 per cent) were above 530 ng. per milliliter, which was the upper normal level in 65 uncomplicated pregnancies. In high-risk pregnancies, the AFP test correctly predicted 60 per cent of the cases with fetal distress and 92 per cent of the cases with normal fetoplacental function. If maternal AFP levels were above 800 ng. per milliliter, fetal distress or intrauterine fetal death occurred in 85 per cent of the cases, and intrauterine fetal death occurred in all 6 cases where the maternal AFP concentration was higher than 1,075 ng. per milliliter. The increase in maternal AFP took place before the fetal death. Clinically established fetal distress was correctly predicted by the AFP test in 2 women whose estriol excretion was normal. The results suggest that the AFP test contributes to the biochemical detection of fetal distress and intrauterine death.