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The origin of α-fetoprotein in first-trimester anembryonic pregnancies

par Jauniaux, Eric ;Gulbis, Béatrice ;Jurkovic, Davor;Gavriil, Panagiotis;Campbell, Stuart A.
Référence American journal of obstetrics and gynecology, 173, 6, page (1749-1753)
Publication Publié, 1995

Article révisé par les pairs

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Résumé :

OBJECTIVE: Our purpose was to evaluate the origin of α-fetoprotein in the maternal circulation and coelomic fluid of pregnancies with an empty gestational sac on first-trimester ultrasonographic examinatin. STUDY DESIGN: The α-fetoprotein level and the affinity of α-fetoprotein for concanavalin A Sepharose was measured between 8 and 11 weeks of gestation in the maternal serum and coelomic fluid of nine pregnancies complicated by an empty gestational sac and of 27 normal pregnancies. RESULTS: The maternal serum α-fetoprotein level in patients with an empty gestational sac was high in seven cases and normal in two cases. In these cases the median level was significantly (p < 0.01) higher in the serum and lower in the coelomic fluid compared with normal pregnancies. In eight cases of the nine pregnancies with an empty sac, >50% of α-fetoprotein molecules in the coelomic fluid were of the concanavalin A nonreactive fraction, whereas in one case the coelomic fluid sample contained <5% of this fraction. A similar distribution was found in the corresponding serum samples. CONCLUSION: Normal or high maternal serum AFP levels and α-fetoprotein molecules predominantly of yolk sac origin in the coelomic fluid of pregnancies with an empty gestational sac on ultrasonography provide further evidence that the most likely explanation for this feature is the early death of the embryo with persistence of the placental tissue. © 1995, All rights reserved.