Elevated Amniotic Alpha‐fetoprotein in Congenital Oesophageal Atresia

Abstract

Summary A case is reported of congenital oesophageal atresia with a broncho‐oesophageal fistula associated with an elevated alpha‐fetoprotein level in amniotic fluid at 34 and 35 weeks of gestation. The mechanism by which this level may become elevated if the fetus has oesophageal atresia is discussed.

Raised alpha-fetoprotein levels in amniotic fluid and maternal serum associated with distension of the fetal bladder caused by absence of urethra.

“…These include congenital nephrosis (Kjessler et al, 1975;Thom et al, 1977), oesophageal atresia (Seppala et al, 1974), duodenal atresia (Weinberg et al, 1975), omphalocele (Nevin and Armstrong, 1975), and Meckel's syndrome (Chemke et al, 1977). In the present report raised amniotic fluid and maternal serum AFP levels were associated with multiple fetal abnormalities including gross distension of the bladder caused by absence of the urethra, intestinal atresia, transposition of the aorta, and an interventricular septal defect.…”

Maternal serum alpha-fetoprotein in fetal anal atresia and other gastro-intestinal obstructions

“…However, the small number of cases limits the statistical power of our study. Elevated AFAFP and/or MSAFP in pregnancies of fetuses with OA or DA have been found by others and ascribed to decreased or absent resorption in the fetal GI tract and increased regurgitation of AFP-rich fetal gastric juice and bile into the amniotic fluid (Seppälä et al, 1974;Thomas and Blakemore, 1990;Weinberg et al, 1975). Table II summarizes data on 29 cases of fetal GI-obstruction and MSAFP/AFAFP levels described in the literature.…”

“…The literature search resulted in four publications describing MSAFP values in pregnancies of fetuses with OA and one study about MSAFP values in pregnancies of fetuses with GI abnormalities (Chodirker et al, 1994;Clarke et al, 1977;Gembruch et al, 1987;Seppälä et al, 1974;Tsukerman et al, 1993). Three fetuses with DA and one with OA were reported in three studies about maternal serum screening for fetal anomalies (Burton and Dillard, 1986;Glick et al, 1988;Norgaard Pedersen et al, 1985).…”