Reactivity of amniotic fluid alpha-fetoprotein with concanavallin A in diagnosis of neural tube defects.

Alpha-fetoprotein (AFP) concanavallin-A-affinity molecular variant patterns were determined in amniotic fluid samples from 10 pregnancies complicated by anencephaly (6), spina bifida (1), Turner's syndrome (1), osteogenesis imperfecta congenita (1), and fetal death (1) and 20 normal pregnancies between 14.6 and 25.5 weeks of gestation. With the exception of one anencephalic pregnancy, the AFP concentrations in samples from women with a fetal abnormality were more than 5 SD above normal for gestational age. In every case, however, the proportion of total amniotic fluid AFP that was not reactive with concanavallin A was significantly smaller in the presence of a fetal abnormality (mean 2%) than when the fetus was normal (mean 20%). The results suggest that measuring the amount of concanavallin-A-non-reactive amniotic fluid AFP will be a valuable test for diagnosing fetal abnormality, especially when an increase in total amniotic fluid AFP concentration is equivocal or gestational age is uncertain.