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Related Experiment Videos

Elevated maternal serum alpha-fetoprotein values. How low is high?

R R Lenke1, J Guerrieri, J M Nemes

  • 1Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo.

The Journal of Reproductive Medicine
|August 1, 1989
PubMed
Summary
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Maternal serum alpha-fetoprotein (MSAFP) screening can detect more than neural tube defects. Lowering the abnormal level cutoff and performing ultrasounds after one abnormal result may improve detection of other pregnancy complications.

Area of Science:

  • Obstetrics and Gynecology
  • Prenatal Diagnostics
  • Maternal-Fetal Medicine

Background:

  • Maternal serum alpha-fetoprotein (MSAFP) screening is primarily used for prenatal detection of fetal neural tube defects.
  • Current screening protocols often result in numerous false-positive results.
  • Standard practice involves identifying abnormal MSAFP levels above 2.5 multiples of the median (MOM) and requiring two abnormal values before ultrasound referral.

Purpose of the Study:

  • To evaluate the utility of MSAFP screening beyond neural tube defect detection.
  • To assess the impact of a lower MOM cutoff and earlier ultrasound referral on obstetric outcomes.
  • To determine if MSAFP screening can identify other significant pregnancy abnormalities.

Main Methods:

  • Pilot program evaluating obstetric outcomes in women with elevated MSAFP levels.

Related Experiment Videos

  • Analysis of data from women with MSAFP values greater than 2.0 MOM.
  • Comparison of outcomes based on revised screening parameters (lower cutoff, earlier ultrasound).

    • Main Results:

    • 21 out of 29 women (72%) with elevated MSAFP (>= 2.0 MOM) experienced significant pregnancy management changes or complications.
    • Elevated MSAFP levels, even below the traditional 2.5 MOM cutoff, were associated with adverse obstetric outcomes.
    • The findings suggest MSAFP's broader utility in identifying potential pregnancy issues.

    Conclusions:

    • MSAFP screening is valuable for detecting a wider range of pregnancy abnormalities, not just neural tube defects.
    • Recommending ultrasound evaluation after a single abnormal MSAFP value (>= 2.0 MOM) is warranted.
    • Lowering the screening cutoff to 2.0 MOM may enhance the detection of significant obstetric complications.