ITIES AND ABNORMAL ALPHA-FETOPROTEIN LEVELS WILLIAM DOBAK, NORA DOYLE, DIAN FOGLE, METHODIUS TUULI, CHRISTINE L. PROUDFIT, PATRICE L. BASANTA-HENRY, TAMULA M. PATTERSON-THOMAS, CHRISTOPHER D. HARVEY, KHADEJA HAYE, EMAD I. ATTA, Emory University, Gynecology & Obstetrics, Atlanta, Georgia OBJECTIVE: Elevated levels of alpha-fetoprotein have been associated with obstetric complications such as neural tube defects, growth restriction, abruption, preterm delivery, fetal demise and preeclampsia. Prior studies have shown that the higher the level of alpha-fetoprotein, the greater the risk for adverse outcome. We sought to identify among patients with abnormal placentas, the correlation of alpha-fetoprotein levels with adverse perinatal outcomes. STUDY DESIGN: Cases of placental abnormalities diagnosed prenatally on ultrasound were identified. Alph-fetoprotein levels for each patient were abstracted from results of the serum quadruple screen. Information on maternal demographics, prenatal sonographic findings, pregnancy complications, antenatal intervention, and perinatal outcomes were obtained by reviewing the medical records and our perinatal database. Perinatal outcomes among patients with both placental abnormalities and high alpha-fetoprotein levels (O2MOM) and those with only placental abnormalities were compared. Chi square, Fisher’s exact test, ANOVA, T –test and logistic regression analysis were performed where appropriate with p less than 0.05 considered significant. RESULTS: In the 6 year period from November 2000 – June 2006 , 184 patients with abnormal placentas were diagnosed prenatally. Of these 71 had AFP values for analysis. Preterm birth (31.4%, p!0.05) and incidence of IUFD (8%, p!0.05) were significantly higher in the group with high AFP values as compared to those with normal AFP. No significant differences in chronic hypertension or cesarean delivery rate between the two groups was noted. CONCLUSION: Placental abnormalities are associated with an increased risk of pregnancy complications, the most common being IUGR, fetal loss, and preterm delivery. From our study the presence of high alpa-fetoprotein levels further increases these risks. Prenatal diagnosis of these two abnormalities may allow for identification and appropriate interventions to reduce these adverse perinatal outcomes. More studies are needed.