Amniotic fluid enzymes in pregnancies with trisomy 21.

Prenatal Diagnosis
M J GiddyI Horacek

Abstract

The activities of a range of microvillous enzymes in amniotic fluid from normal pregnancies (n = 213) and those complicated by trisomy 21 (n = 26) were compared in a prospective study. Using a centrifugal analyser, the activities of leucine aminopeptidase (LAP), gamma glutamyl transferase (GGT), aspartate transferase (AST), and isoenzymes of alkaline phosphate (ALP) were measured in amniotic fluid alongside alpha fetoprotein (AFP) levels. Of the markers studied, LAP was found to be the most reliable indicator of trisomy 21. Using levels below the 5th percentile, LAP showed sensitivity 73 per cent, specificity 94 per cent, and predictive value positive 63 per cent. Although these tests would not replace karyotyping in all cases, the measurement of LAP could be useful as a rapid initial screening test, particularly when amniocentesis is performed for indications other than chromosomal abnormalities.

References

May 1, 1988·Prenatal Diagnosis·B F CrandallS Perdue
Feb 2, 1985·Lancet·H S CuckleJ Jonasson

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Citations

Nov 13, 2001·BJOG : an International Journal of Obstetrics and Gynaecology·L BurcD Luton
Sep 1, 1993·British Journal of Obstetrics and Gynaecology·T E IndT Chard
Jan 5, 2002·BJOG : an International Journal of Obstetrics and Gynaecology·R YamamotoS Fujimoto

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