Fetal Bladder-Neck Obstruction and Elevated Amniotic-Fluid Alpha Fetoprotein

To the Editor: The alpha-fetoprotein assay is a useful tool in the antenatal detection of neural-tube defects.¹ Several other nonspecific abnormalities, including Turner's syndrome,² omphalocele,³ esophageal atresia,⁴ congenital nephrotic syndrome,⁵ duodenal atresia⁶ and fetal death,⁷ have been associated with elevated alpha-fetoprotein levels in the amniotic fluid. Abnormal levels may also be caused by contamination of amniotic fluid by fetal blood. In the following case elevated amniotic-fluid alpha fetoprotein was associated with a fetal bladder-neck obstruction due to a posterior mucosal fold.A 37-year-old gravida 2, para 1, was referred for prenatal chromosome studies because of age. An amniocentesis at 16 . . .