Early Diagnosis of Trophoblastic Disease and Fetal Maldevelopment by Determination of Alpha-Fetoprotein (AFP), Human Chorionic Gonadotrophin (HCG) and Amniography
Combined biochemical and radiological investigations were done in 7 patients with confirmation and refutation, respectively, of suspected diagnoses, such as trophoblastic disease and neural-tube defects. Amniography is simple to perform, and rapidly provides accurate information with regard to specific pregnancy disorders, e.g., trophoblastic disease and certain types of fetal maldevelopment. No significant adverse effects on mother or infant have so far been reported when a water-soluble contrast medium has been utilized in early pregnancy. It seems not even to be critical to know for certain whether a living fetus is present or not, before the procedure is initiated. The possibility to combine a scheduled transabdominal amniocentesis for amniotic fluid sampling with a concomitant amniography should be considered in selected cases. Such a combined procedure may reduce the total risk run by mother and fetus by possibly making a repeat amniocentesis unnecessary should, e.g., the AFP content in the 1st sample be found to be elevated. It therefore appears that a combination of different quantitative immunological analyses, e.g., AFP in maternal serum and amniotic fluid, and hCG in maternal serum or urine, may primarily disclose certain patients to be at risk for trophoblastic disease or severe fetal maldevelopment in early pregnancy. Rapid and accurate confirmation or refutation of the suspected diagnosis may then be achieved by subsequent amniography, a simple and reliable radiologic investigative procedure.