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ALPHA‐FETOPROTEIN LEVELS IN AMNIOTIC FLUID IN PREGNANCIES COMPLICATED BY RHESUS ISOIMMUNIZATION

Alpha‐fetoprotein (AFP) has been estimated in 249 samples of amniotic fluid from 71 patients, 60 of whom had rhesus isoimmunization. No difference was found between the AFP levels in unaffected pregnancies, pregnancies complicated by mild or moderate disease or in severe rhesus isoimmunization when the baby survived. However, in the severe group with an unfavourable fetal outcome, 42 per cent of the cases had amniotic fluid levels of AFP which were above 5.5 mg. /ml. on one or more occasions. In the most severely affected cases a correlation existed between the amniotic fluid AFP levels and both the optical density difference (Δ) at 450 mμ and protein concentration in the liquor amnii. Erroneously elevated amniotic fluid levels of AFP may be found when the fluid has been contaminated by ascitic fluid or fetal blood. It is suggested that the level of AFP in amniotic fluid taken in conjunction with the Δ 450 mμ, peak might be a valuable guide in identifying the severely affected pregnancy in which the fetal prognosis is grave.