Then the scenario would be as follows: A woman is not offered MSAFP
screening, or claims to have been inadequately informed and not understood what she was refusing, or (as in one case at a California HMO) the health care provider loses the consent form that indicated the patient's refusal.
Pregnant patients with insulin-dependent diabetes have AFPs that are about 25 to 40 per cent lower (according to which reference you use) than their nondiabetic counterparts at comparable durations of gestation.2 If the MSAFP
request form indicates diabetes, the lab should either automatically correct for its presence by using a lower set of median values for each gestational week or append a comment on the relationship between diabetes and low MS-AFPs.
, usually report by multiples of the mean, MoM.
Laboratory investigations NESTROFT followed by HB A2 estimation and MSAFP
were carried out in 2548 cases.
She discussed folic acid with the mother; who refused MSAFP
testing when it was suggested.
By the mid-1980s, the merit of MSAFP
use in screening for Down syndrome among women younger than 35 had been recognized.
Chromosome specific confined placental mosaicism associated with unexplained isolated second trimester elevation of MSAFP
levels and normal MShCG and estriol levels [abstract].
Another new test being offered around the 16th week is the maternal serum alpha-fetoprotein (MSAFP
) screening test, which identifies women at risk of having babies with neurotubal birth defects.
Women with an initial maternal serum alpha-fetoprotein (MSAFP
) sample that's more than 2.2 multiples of the median (MoM) but less than 3 MoM who then have a normal second sample do not have an elevated risk of fetal anomalies.
Next, an obsteizician takes over and treats her pregnancy as normal, scheduling routine chorionic villus sampling (CVS) -- result: normal -- then maternal serum alpha-fetoprotein screening (MSAFP
) -- result: elevated levels of AFP.
(%) Reason for Ultrasound Scan of Patients Discrepancy between size and clinically estimated 71 (31.0) gestational age Uncertainty about last menstrual period 63 (28.0) Growth assessment 9 (4.0) Preterm labor 5 (2.0) Absent fetal heart tones 8 (3.5) Bleeding 19 (8.5) Abnormal MSAFP
test, suspected anomaly, or in 8 (3.5) conjunction with genetic amniocentesis Maternal complications (diabetes, toxemia, or 17 (7.5) previous cesarean section) Miscellaneous 28 (12.0) Seven of the 228 patients reported having had a cholecystectomy, and therefore were ineligible for the study.
On the other hand, elevated levels of both inhibin A and maternal serum alpha-fetoprotein (MSAFP
) had a positive likelihood ratio of 15.77.