title: A co-twin fetus papyraceus as a cause of elevated AFP and acetylcholinesterase in the amniotic fluid of the normal co-twin.
abstract: An elevated amniotic fluid alpha-fetoprotein (AF-AFP) level together with a positive acetylcholinesterase (AChE) band is strongly predictive of neural tube defect (NTD) in the fetus. We report such results in a pregnancy in which the fetus was found to be normal after termination. Among the placental fragments was found a sac containing a prenatally undetected co-twin fetus papyraceus. We suggest that pregnant women with such laboratory results but lacking sonographic evidence of NTD should have a high-level untrasonographic investigation, as well as a thorough pathologic examination of both placenta and fetus in cases of termination.
authors.affiliation: Department of Pediatrics, Montreal Children's Hospital, McGill University, Quebec, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Chitayat
authors.forename: D K
authors.initials: DK
authors.lastname: Kalousek
authors.forename: B C
authors.initials: BC
authors.lastname: McGillivary
authors.forename: D A
authors.initials: DA
authors.lastname: Applegarth
mesh_terms: D000110:Acetylcholinesterase / Q000378:metabolism*; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000378:metabolism*; D005260:Female; D005313:Fetal Death; D006801:Humans; D011247:Pregnancy; D011272:Pregnancy, Multiple; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000509:alpha-Fetoproteins; D000110:Acetylcholinesterase