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Does an abnormally elevated maternal alkaline phosphatase pose problems for the fetus?
  1. Sarah McErlean and
  2. Chris King
  1. Obstetrics and Gynaecology, Letterkenny University Hospital, Letterkenny, Ireland
  1. Correspondence to Dr Sarah McErlean, sarahmcerlean{at}


We report a potential association between an abnormally raised pregnancy level of alkaline phosphatase (ALP) and intrauterine growth restriction (IUGR). There are few reports of women with abnormally high ALP during pregnancy. However, there is work to suggest an association with placental insufficiency, low birth weight and preterm delivery. In conjunction with a rising ALP, fetal IUGR and intermittent absence of umbilical artery end diastolic flow had evolved. A greatly elevated ALP may be a marker for placental insufficiency and IUGR.

  • pregnancy
  • materno-fetal medicine

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  • Contributors SM was directly involved in the care of this patient, obtained informed consent and wrote up the main body of the case report. CK was the supervising consultant who made key clinical decisions and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.