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The clinical significance of low maternal serum alpha-fetoprotein

Lowered maternal serum alpha-fetoprotein was retrospectively investigated in 20,000 patients who underwent prenatal maternal serum alpha-fetoprotein screening. Two hundred thirty-two patients were initially evaluated as having maternal serum alpha-fetoprotein levels less than 0.25 multiple of the normal median. Correction factors, such as incorrect estimation of gestational age, reduced to 180 the number of patients with low alpha-fetoprotein. In this target group, patients with known pregnancy outcomes sustained a fetal loss in 38% of the cases. It appears that significantly low maternal serum alpha-fetoprotein is associated with a dramatic increase in second-trimester fetal wastage.

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