HighAFP (Alpha Feto- Protein) Levels in Pregnancy

Dr Deepika Tiwari, Consultant Obstetrician & Gynaecologist, Sohna Road, Gurgaon 9911821669

All pregnant women should be offered the MSAFP (Maternal Serum Alpha Feto Protein) screening, but it is especially recommended for: 
Women who have a family history of birth defects
Women who are 35 years or older
Women who used possible harmful medications or drugs during pregnancy
Women who have diabetes mellitus

It is important to remember that the AFP is a screening test and not a diagnostic test. This test only notes that a mother is at risk of carrying a baby with a potential disorder. There are approximately 25 to 50 abnormal test results for every 1,000 pregnancies tested.  Of these abnormal results, only 1 in 16 to 1 in 33 will actually have a baby that has been affected with a neural tube defect or other condition.  The benefit of screening is that 75% to 90% of babies with neural tube defects are discovered.

An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnantwoman can help see whether the baby may have such problems asspina bifida and anencephaly. An AFP test can also be done as part of a screening test to find other chromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18)

The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type ofestrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

An ultrasound will likely be done if the AFP is abnormal. If an ultrasound cannot find the cause of the abnormal AFP, an amniocentesis may be recommended.