<prompt> Alpha-fetoprotein in maternal serum andor amniotic fluid is increased in all exceptFetal neural tube defectsDowns syndromeAnencephalyEncephalocele  <response>: In Down syndrome, the AFP is decreased in the mothers blood, presumably because the yolk sac and fetus are smaller than usual. Estriol is a hormone produced by the placenta, using ingredients made by the fetal liver and adrenal gland. Estriol is decreased in the Down syndrome pregnancy Ref Robbins 9e pg 170 