Maternal serum alpha‐fetoprotein levels and fetal outcome in early second‐trimester oligohydramnios

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Abstract
Early second‐trimester oligohydramnios was associated with normal maternal serum alpha‐fetoprotein (MSAFP) levels in nine out of 26 cases (35 per cent). Congenital malformations of the fetal urinary tract resulting in fetal anuria were present in nine cases; in seven of them, normal MSAFP levels were measured. In contrast, normal MSAFP levels were established in only 2 out of the 17 cases without fetal malformations. These data suggest that fetal urine is the major source of elevated AFP in the maternal compartment in early second‐trimester oligohydramnios. This is further supported by the lack of any relationship between concentrations of MSAFP non‐reactive with Concanavalin A, originating mainly from the yolk sacderived amniotic fluid AFP pool, and the presence of fetal diuresis. Three out of 26 women had experienced early second‐trimester oligohydramnios in a previous pregnancy, suggesting the existence of a recurrence risk for this condition.