Unexplained elevated maternal serum alpha-fetoprotein: what is the appropriate follow-up? 1998

L Wilkins-Haug
Antenatal Diagnostic Center, Brigham and Women's Hospital, Boston, MA 02115, USA.

Unexplained elevations of maternal serum alpha-fetoprotein exist in approximately 1% of the obstetric population. A consensus has been reached that these women face an increased risk of adverse pregnancy outcome. Whether their overall risk can be altered by the currently available surveillance modalities, however, remains controversial. Current research has focused on identifying those pregnancies with the highest risks of either fetal growth restriction, pre-eclampsia, preterm delivery or intrauterine fetal demise. Markedly increased maternal serum alpha-fetoprotein (over 4.0 multiples of the median), elevations of other serum markers such as human chorionic gonadotropin and abnormal umbilical Doppler flow are associated with the greatest risk of poor pregnancy outcome. When initiating surveillance of the pregnancy with unexplained elevated maternal serum alpha-fetoprotein consideration of these factors is receiving increased attention.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D011262 Pregnancy Trimester, Second The middle third of a human PREGNANCY, from the beginning of the 15th through the 28th completed week (99 to 196 days) of gestation. Midtrimester,Pregnancy, Second Trimester,Trimester, Second,Midtrimesters,Pregnancies, Second Trimester,Pregnancy Trimesters, Second,Second Pregnancy Trimester,Second Pregnancy Trimesters,Second Trimester,Second Trimester Pregnancies,Second Trimester Pregnancy,Second Trimesters,Trimesters, Second
D011295 Prenatal Care Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. Antenatal Care,Care, Antenatal,Care, Prenatal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000509 alpha-Fetoproteins The first alpha-globulins to appear in mammalian sera during FETAL DEVELOPMENT and the dominant serum proteins in early embryonic life. alpha-Fetoprotein,alpha Fetoprotein,alpha Fetoproteins
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor

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