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Is unexplained elevated maternal serum alpha-fetoprotein still important predictor for adverse pregnancy outcome?

When increased maternal AFP levels are found in pregnant women with a correct gestational age, normal fetus structure and normal amniotic fluid AFP levels, the general biological explanation is usually that some damage has occurred at the maternal-fetal interface, which results in elevated levels of AFP in maternal circulation. In a number of studies, using MSAFP cut-off values of 2.0 to 3.0 MoM, low birth weight, intrauterine growth retardation (IUGR), premature delivery, placental abruption, intrauterine fetal death (IUFD), preeclampsia and increased risk of perinatal death were found in pregnant women with AFP levels above this value...

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Articles of Interest

Unexplained Elevated Maternal Serum Alpha-fetoprotein in Singleton Pregnancies as a Predictor of Fetal Risk

This study suggests that patients with unexplained midtrimester elevations of MSAFP are increased risk for IUGR, preterm labor. But no significance differences were observed in the incidence of low birth weight, antepartum hemorrhage ( placental previa ), PIH.

Alpha Fetoprotein (AFP)Tumor Marker and Role in Pregnancy

In clinical medicine, AFP has gained prominence as both a biochemical marker of fetal health and a tumor marker in adults. Elevated or decreased levels of AFP can provide valuable diagnostic information in various physiological and pathological conditions. For example, maternal serum AFP (MSAFP) testing is widely used for prenatal screening of neural tube defects and chromosomal abnormalities, while in adults, serum AFP testing serves as a key biomarker in hepatocellular carcinoma (HCC) and germ cell tumors.

Is MSAFP Still a Useful Test for Detecting Open Neural Tube Defects and Ventral Wall Defects in the Era of First-Trimester and Early Second-Trimester Fetal Anatomical Ultrasounds?

Ultrasound for fetal anatomy during the first and early second trimester detected 100% of ONTD/VWD in our population. MSAFP is not useful as a screening tool for ONTD and VWD in the setting of this ultrasound screening protocol.

MSAFP (maternal serum alpha-fetoprotein screening)

The primary usage of this screening is to detect neural tube defects like spina bifida, where the fetus’s spine does not develop correctly, or anencephaly, a severe neural tube defect causing underdevelopment of the brain. An elevated level of AFP is commonly correlated with these conditions. Moreover, this screening also helps in recognizing potential abnormalities in the abdominal wall of the fetus, multiple pregnancies (twin, triplet, etc.) or misestimate of pregnancy dating.

The association between maternal serum alpha-fetoprotein and preterm birth, small for gestational age infants, preeclampsia, and placental complications

Low levels of second-trimester maternal serum AFP are associated with a very low risk of preterm birth, preeclampsia, and placental complications. High levels of serum AFP are strongly associated with preterm birth, preeclampsia, and placental abnormalities. There is a modest association between AFP levels (both low and high) and SGA birth.

Understanding the Maternal Serum Alpha-Fetoprotein Test

Maternal serum alpha-fetoprotein (AFP) testing plays a pivotal role in prenatal care, offering valuable insights into the health of both the expectant mother and her developing baby. This simple blood test, often referred to as the AFP test, is a cornerstone of second-trimester prenatal screening. It helps healthcare providers assess the risk of certain birth defects, including neural tube defects and chromosomal abnormalities such as Down syndrome.