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Very low maternal plasma alpha-fetoprotein concentration. An indication for follow-up
British Journal of Obstetrics and Gynaecology
|June 1, 1981
Summary
Low maternal plasma alpha-fetoprotein (AFP) levels during pregnancy screening may indicate a non-viable fetus or inaccurate gestational age. Further investigation is crucial for accurate diagnosis in these cases.
Area of Science:
- Obstetrics and Gynecology
- Prenatal Diagnostics
- Biochemistry
Background:
- Maternal plasma alpha-fetoprotein (AFP) screening is used to detect fetal neural tube abnormalities.
- Very low AFP levels can be a concerning indicator during pregnancy.
Purpose of the Study:
- To investigate the reasons for very low maternal plasma AFP levels detected during routine screening.
- To evaluate the outcomes for pregnancies with low AFP levels.
Main Methods:
- Identified 57 patients with maternal plasma AFP levels < 7 units/ml at 15-20 weeks gestation.
- Follow-up included pregnancy confirmation and repeat AFP testing.
- Assessed fetal viability and gestational age accuracy.
Main Results:
- Of 55 patients with follow-up data, 17 (31%) had non-viable fetuses.
- 31 patients (56%) had incorrect gestational age estimates.
- No cause was identified for very low AFP in the remaining 7 patients.
Conclusions:
- Very low maternal plasma AFP levels are frequently associated with non-viable pregnancies or inaccurate gestational dating.
- These findings highlight the importance of careful follow-up for low AFP results.