Case reports urine is a major source of amniotic fluid AFP, urethral obstruction alone would result in a low amniotic AFP level, as in disorders associated with renal dysgenesis. The raised amniotic fluid and maternal serum AFP is most probably caused by regurgitation of bile and gastric contents into the amniotic fluid due to intestinal atresia. Transudation of fetal serum as a result of the gross abdominal distension is unlikely. In omphaloceles with exposure of blood vessels, easy transudation of fetal serum will result in increased amniotic fluid AFP (Nevin and Armstrong, 1975; Weiss et al., 1976), but when the exomphalos is covered with skin amniotic fluid AFP is normal.Fortunately, in most instances where a high AFP level has been found in the absence of a neural tube defect, the fetal abnormalities have been so serious as not to compromise the validity of termination of the pregnancy because of the high AFP value.
Previous reports have noted a constant association between the Carpenter syndrome (acrocephalopolysyndactyly, type II) and mental retardation. We report two patients with this condition with normal intelligence. These observations indicate that mental deficiency is not necessarily a component of the Carpenter syndrome and that early surgical correction of the craniosynostoses may improve the chances of normal mentality.
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