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Total and free T3 and T4 concentrations were measured in human amniotic fluid and in fetal and maternal blood. Before 20 weeks, the mean AF-T4 level was 0.24 mug/dl; there is a progressive increase in concentration with gestational age. At term, the mean AF total T4 level was much less (0.64 mug/dl) than in fetal or maternal serum (9.3 and 11.3 mug/dl, respectively). Most of the T4 (99.4%) in AF is protein bound, presumably to TBG as in serum, but the mean FT4 concentration in AF at term (4.13 ng/dl) was significantly greater than the levels in fetal or maternal serum (2.67 or 2.56 ng/dl, respectively). The mean TBG level in AF at term was 0.26 mg/dl. T3 was not measurable in AF (less than 15 ng/dl). There were no significant correlations between the total or free T4 concentrations in maternal or fetal sera and in amniotic fluid. Thus AF thyroid hormone concentrations in the euthyroid fetus do not reliably reflect fetal serum T4 or T3 concentrations.
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