Raised maternal plasma alpha-fetoprotein and pregnancy outcome

With the aim of evaluating the clinical value of raised maternal plasma alpha-fetoprotein (AFP) in women with singleton fetuses without structural abnormalities, the outcome of pregnancy was evaluated in a group of 20 women with these characteristics. Only 6 women (30%) delivered fetuses with appropriate birthweight at term; there were 6 pregnancy losses (30%), and the remaining pregnancies ended in pre-term delivery and/or birth of a small for gestational age fetus. Ultrasound examination supplied additional information in 3 cases only. Amniocentesis did not seem to affect pregnancy outcome in this group of high-risk pregnancies. Serial AFP testing was useless for monitoring these pregnancies. It is concluded that raised maternal plasma AFP must be regarded as a marker of poor pregnancy outcome even after exclusion of neural tube defects.