Alphafoetoprotein and acetylcholinesterase in amniotic fluid as a factor suggesting fetal skin and nerve lesions in a case of congenital varicella syndrome.
BACKGROUND
Prenatal care of pregnant women exposed to varicella skin rash during the first half of pregnancy remains a frequent concern in countries that do not have access to systematic vaccination. The frequency of maternofetal transmission is low. Ultrasound is the usual tool for prenatal survey of exposed fetuses. But many anomalies due to VZV infection are not accessible to ultrasound alone.


METHODS
We review a case in which the diagnosis of fetal infection suspected due to transient fetal bowel hyperechogenicity was confirmed in amniotic fluid by molecular biology (PCR).


RESULTS
An unusual elevation of alphafoetoprotein in maternal blood and in amniotic fluid was associated with inguinal skin, muscular and nerve destruction.


CONCLUSIONS
In fetuses diagnosed with in utero varicella infection, in addition to a precise diagnosis and follow-up, we suggest that elevated AFP levels in maternal blood and amniotic fluid together with the presence of acetylcholinesterase in amniotic fluid may be related to lesion of fetal skin and nerves.
Fetal Medecine Unit, Institut de puériculture et périnatalogie, Paris, France. mirlesse.v@free.fr
Véronique
V
Mirlesse
Nathalie
N
Duguy
Evelyne
E
Cynober
Jean
J
François Magny
Fernand
F
Daffos
D000110:Acetylcholinesterase / Q000032:analysis*; D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000201:enzymology / Q000821:virology; D001342:Autonomic Nervous System Diseases / Q000151:congenital / Q000175:diagnosis / Q000821:virology; D002644:Chickenpox / Q000150:complications / Q000151:congenital* / Q000175:diagnosis* / Q000196:embryology; D005260:Female; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000821:virology; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D011379:Prognosis; D017193:Skin Diseases, Viral / Q000151:congenital* / Q000175:diagnosis / Q000821:virology; D016216:Ultrasonography, Prenatal; D000509:alpha-Fetoproteins / Q000032:analysis*
D000509:alpha-Fetoproteins; D000110:Acetylcholinesterase