Early Diagnosis of Trophoblastic Disease and Fetal Maldevelopment by Determination of Alpha‐Fetoprotein (AFP), Human Chorionic Gonadotrophin (HCG) and Amniography

Early diagnosis of trophoblastic disease and fetal maldevelopment by determination of alpha fetoprotein (AFP) human chorionic gonadotropin (HCG) and amniography is reported. 4 of the patients presented with early clinical symptoms of abnormal pregnancy development and 3 had repeatedly displayed elevated AFP levels in maternal serum and amniotic fluid. The combination of a nonpregnant level of AFP in maternal serum and a normal or raised level of HCG in maternal serum or urine is an important indicator of the presence of biologically active trophoblastic cell elements with the concomitant absence of vital yolk sac-derived cell elements. Raised AFP levels in maternal serum and amniotic fluid were observed in a variety of fetal developmental defects however the clinical importance of these defects may vary from utterly severe and incurable conditions to completely insignificant and benign lesions. Amniography is safe simple to perform and rapidly provides accurate information with regard to specific pregnancy disorders such as trophoblastic disease and certain types of fetal maldevelopment. In selected cases the possibility to combine amniocentesis with a concomitant amniography should be considered. It appears that a combination of AFP and HCG analyses may primarily disclose certain patients to be at risk for trophoblastic disease or fetal maldevelopment confirmation or refutation of the suspected diagnosis may then be achieved by subsequent amniography.