Increased Alpha Fetoprotein in Amniotic Fluid Associated With a Congenital Esophageal Atresia of the Fetus

Abnormally elevated concentrations of alpha fetoprotein (AFP) in amniotic fluid and maternal serum have been associated with developmental disorders of the fetus. A case is reported of a 43-year old woman in whom amniotic fluid concentrations of AFP were approximately 10 times higher than normal at 37-38 weeks gestation and the maternal serum concentration was normal (both values were determined by radioimmunoassay). The patient delivered a male infant in whom esophageal atresia was diagnosed roentgenographically. The high AFP level seen in the absence of severe fetoplacental dysfunction in this case may result from disturbed fetal liver function primarily associated with esophageal atresia or resulting from a disturbed circulation of amniotic fluid through the intestine to the portal vein.