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Elevated maternal serum alpha-fetoprotein and mild fetal uropathy
B M Petrikovsky1, D A Nardi, J F Rodis
1Department of Obstetrics and Gynecology, State University of New York, Stony Brook.
Obstetrics and Gynecology
|August 1, 1991
Summary
Elevated maternal serum alpha-fetoprotein (MSAFP) may indicate fetal pyelectasis, a mild urinary tract issue. This finding is crucial for prenatal diagnosis when neural tube defects are ruled out.
Area of Science:
- Maternal-fetal medicine
- Prenatal diagnostics
- Medical imaging
Background:
- Elevated maternal serum alpha-fetoprotein (MSAFP) levels are a key indicator in prenatal screening.
- MSAFP is primarily associated with open neural tube defects.
- Other potential causes for elevated MSAFP require further investigation.
Purpose of the Study:
- To investigate the association between elevated MSAFP and genitourinary tract abnormalities in fetuses.
- To determine if MSAFP elevation correlates with conditions like pyelectasis.
- To explore potential links between MSAFP and mild uropathy in the second trimester.
Main Methods:
- Retrospective analysis of 61 patients with elevated MSAFP and 80 controls.
- Second-trimester ultrasound of the fetal genitourinary tract performed by blinded ultrasonographers.
- Phenotypic sex assignment independent of MSAFP results.
Main Results:
- Male fetuses with elevated MSAFP showed a 33% incidence of pyelectasis versus 5% in controls.
- Female fetuses exhibited a 16% incidence of pyelectasis compared to none in controls.
- A significant correlation was observed between elevated MSAFP and fetal pyelectasis.
Conclusions:
- Increased MSAFP, excluding open neural tube defects, can be associated with mild fetal uropathy.
- Second-trimester ultrasound is valuable for detecting genitourinary abnormalities in cases of elevated MSAFP.
- This finding aids in refining differential diagnoses for elevated MSAFP during prenatal screening.