Neuron specific enolase in amniotic fluid--a possible indicator for fetal distress and brain implication

It can be suggested that a NSE concentration in body fluids above the normal range may indicate brain damage, because NSE is found in neurons and neuroendocrine cells only. In this paper the concentration of the neuron specific enolase (NSE) in the amniotic fluid of normal and high risk pregnancies was investigated. Sixty-three samples of amniotic fluid were collected from 55 pregnant women and women in labor between the 19th and the 42nd gestational week. In 24 normal pregnancies 1.02 +/- 0.31 microgram NSE/L (mean +/- SD) were found. A relationship of NSE concentration was not found for gestational age, uterine contractions, age and parity of the mother, infant's birth weight or 1 min Apgar score. Maternal diseases such as diabetes mellitus, hypertension and others do not result in any increase of NSE concentration in the amniotic fluid (N = 20; 1.06 +/- 0.24 microgram NSE/L). Fetal and birth related high risk factors such as meconium stained amniotic fluid, cord around the neck, severe decelerations of the fetal heart rate or combinations of these factors caused the NSE concentration to exceed significantly normal values (N = 17; 2.22 +/- 0.87 microgram NSE/L). Due to its high organ and cell specificity, NSE may be a possible parameter for brain damage due to hypoxia in the fetus and newborn; however, only subsequent neurological and psychological examinations of these children can indicate the prognostic value of an elevation of NSE concentration in amniotic fluid.