Alpha Fetoprotein and Human Placental Lactogen Levels in Maternal Serum 1n Multiple Pregnancies

Summary Alpha fetoprotein (AFP) and human placental lactogen (HPL) concentrations were measured in maternal serum by radioimmunoassay. Compared with normal single pregnancies, both AFP and HPL concentrations were elevated in multiple pregnancies. Among twin pregnancies, AFP levels exceeding the normal 97.5th centile were associated with intrauterine fetal death in 4 of 7 cases, while fetal death occurred in only 1 of 12 where the maternal AFP concentration was normal. HPL levels in twin pregnancies were below the normal median if the fetus died in utero . The combined efficacy of both AFP and HPL levels in the monitoring of twin pregnancies was assessed. The efficacy of either marker was increased by the concomitant application of the other.