Elevated Maternal Serum Alpha-Fetoprotein Caused by Midtrimester Amniocentesis

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Abstract
In a prospective investigation, 247 patients underwent ultrasonically guided midtrimester amniocentesis. Maternal serum .alpha.-fetoprotein (AFP) was measured before and after the procedure. In 229 patients, preamniocentesis AFP exceeded 19 .mu.g/l. Forty-eight (21.0%) of these displayed a significant elevation of AFP induced by the procedure, indicating fetal-maternal bleeding. This event was correlated with anterior placental location (P < 0.025) and was followed by a significantly reduced mean fetal birth weight (3143 vs. 3385 g, P < 0.05). In addition, a nonsignificant (0.10 < P < 0.20) doubling of the risk of giving birth to a child small for gestational age was observed. Amniocentesis could represent a potential hazard to the fetus. The implications in relation to the widening indications for amniocentesis are discussed.

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