Abstract
Design: Retrospective analysis. Setting: East London Hospital. Subjects: 724 women who had maternal serum alphafetoprotein levels measured between 15 to 19 weeks gestation. Main outcome measure: The main outcome measures were defined as any case of preeclampsia, small-for-gestational age (SGA) birth- weight th centile, placental abruption, stillbirth or early neonatal death. Methods: Women with MSAFP > 2.0 Multiples of Median (MoM) were classified as screen positive. Results: 41 (5.7%) women developed preeclampsia. Women with MSAFP > 2.0 Multiples of the Median (MoM) were significantly more likely to develop preeclampsia (p th centile (p
Highlights
Alpha-fetoprotein is a glycoprotein produced by the fetal liver and gastrointestinal tract
Main outcome measure: The main outcome measures were defined as any case of preeclampsia, small-for-gestational age (SGA) birthweight < 5th centile, placental abruption, stillbirth or early neonatal death
Unexplained elevated MSAFP in the second trimester was strongly associated with a subsequent risk of pre-eclampsia especially those requiring preterm delivery, as well as other complications related to uteroplacental insufficiency
Summary
Alpha-fetoprotein is a glycoprotein produced by the fetal liver and gastrointestinal tract. Increased maternal serum levels of AFP are the consequence of increased amniotic fluid concentration in association with fetal defects including exomphalos and open spina bifida; increased transfer from the fetal to maternal circulation as a consequence of placental damage and increased production in the mother from germ cell tumours, hepatocellular carcinoma and metastatic cancer in the liver [1]. It has been used as a marker of open neural tube defects e.g. spina bifida and will detect up to 85%. Most women with unexplained elevated values do not have a fetus with NTD; only 1 in 15 women with elevated MSAFP has a neural tube defect
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