Fetal liver function tests: umbilical cord gamma-glutamyltransferase as a marker for fetal abnormality

The objective was to assess the association of fetal liver function tests in various (noninfectious) abnormal fetal conditions. Liver function tests and complete blood counts were evaluated in 72 consecutive fetal blood specimens obtained by cordocentesis. The indications for cordocentesis included: fetal malformation (24), red blood cell alloimmunization (23), possible fetal infection (17), oligohydramnios (5), and immunologic thrombocytopenic purpura (3). Statistical analysis included analysis of variance and linear regression analysis. Liver function tests including total protein, albumin, total bilirubin, alanine and aspartate aminotransferase were all within the range of previously published normal values. However, fetal gamma-glutamyltransferase levels (mean +/- SEM) were 157.1 +/- 15.1 IU/l (norm: 24.4 +/- 1.2 IU/l; p < 0.001). There were no statistically significant differences in the gamma-glutamyltransferase levels between the various groups of fetal abnormalities. Mean fetal gamma-glutamyltransferase levels in 8 normal fetuses were 106.2 +/- 17.5 IU/l. In conclusion, fetal gamma-glutamyltransferase levels are significantly elevated in several abnormal fetal conditions.