[Maternal serum AFP screening in type I diabetic patients]

The work is a clinical report of alpha-fetoprotein (AFP) estimations in maternal serum samples of patients with an insulin dependent diabetes mellitus (IDDM). Venous blood samples for AFP estimations wer taken between the 14th and 20th week of pregnancy. In the first line the AFP detections support the diagnosis of open neural tube defects (NTD). On the other side low maternal AFP serum values are suspicious regarding to fetal forms of trisomia. In the present study a radioimmunological method (RIA) was used for AFP determinations (CIS, Paris, France). The acceptance of high AFP concentrations was effected by the 2.5 X median; low concentrations were detected by using the 0.4 X median and 10 micrograms/l respectively. In two cases (0.9%) we found high maternal AFP levels (greater than 2.5 X median). After clinical observation these levels had been caused by an abortion and gemini respectively. There was not any correlation between AFP and glycosylated hemoglobin (HbA1), a standard parameter of metabolic control, and even no correlation to fetal macrosomia and diabetic fetopathia. Ther were no neural tube defects in the time of investigation. Regarding to relative large group of low AFP-levels without fetal chromosomal anomalies, these present results are directing to an enlarged screening programm of fetal forms of trisomia.