Exxcellence pearls: elevated maternal AFP Flashcards Preview

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Flashcards in Exxcellence pearls: elevated maternal AFP Deck (9)
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0
Q

Where is fetal alpha-fetoprotein produced?

A

Fetal liver

1
Q

When do levels of maternal serum alpha-fetoprotein rise?

A

Second trimester

2
Q

How are abnormal AFP results described?

A

Multiples of the median. Levels greater than 2.5 for specific week of gestation are considered elevated.

4
Q

What factors are sometimes used to modify calculations of AFP multiples of the median?

A

Maternal weight, race, diabetes mellitus

4
Q

How is maternal AFP affected by a fetus with Down syndrome?

A

Reduced by approximately 25%

5
Q

What does elevated AFP typically suggest?

A

Open fetal defect such as spina bifida, anencephaly, or abdominal wall defect

6
Q

What can cause false positives for AFP?

A

Under estimation of gestational age, multi-fetal pregnancy, fetomaternal hemorrhage.

7
Q

How should elevated AFP be followed up?

A

Ultrasound. Historically amniocentesis for amniotic fluid AFP was performed.

KB fetal cells staining should be considered for Rh negative women.

8
Q

What ultrasound findings are suggestive of spina bifida?

A

“Lemon sign” and “banana sign”.

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