Johnson V P, Vidgoff J, Wilson N, Madison D
Department of Obstetrics and Gynecology, University of South Dakota School of Medicine, Vermillion 57069.
Prenat Diagn. 1989 Dec;9(12):831-7. doi: 10.1002/pd.1970091203.
Twins concordant for elevated alpha-fetoprotein (AFP) and acetylcholinesterase (AChE) and discordant for neural tube defect (NTD) and sex are reported. A literature review reveals instances of termination of twin pregnancies with one normal and one abnormal fetus, partly based on concordant high AFP and positive AChE (although discordant on ultrasound examination). The levels of AFP and AChE in twin pregnancies are probably a function of the number of layers of fetal membranes separating twin sacs; dichorionic, diamniotic membranes allow transfer of AFP; monochorionic, diamniotic membranes allow transfer of both AFP and AChE. Cautious interpretation of biochemical findings and reliance on high resolution ultrasonography are suggested.
据报道，有双胞胎的甲胎蛋白（AFP）和乙酰胆碱酯酶（AChE）升高且神经管缺陷（NTD）和性别不一致。文献综述显示，有双胎妊娠中一个胎儿正常而另一个异常时终止妊娠的情况，部分原因是AFP一致升高和AChE阳性（尽管超声检查结果不一致）。双胎妊娠中AFP和AChE的水平可能取决于分隔双胎囊的胎膜层数；双绒毛膜、双羊膜的胎膜允许AFP转移；单绒毛膜、双羊膜的胎膜允许AFP和AChE都转移。建议谨慎解读生化检查结果并依赖高分辨率超声检查。
