Unexplained Elevated Maternal Serum Alpha-fetoprotein in Singleton Pregnancies as a Predictor of Fetal Risk

Yang, Yun Seok

Abstract

The aim of the study was to evaluate the significance of unexplained elevated mater- nal serum alpha-fetoprotein in singleton pregnancies as a prediction of fetal risk. The inclusion criteria for patents with unexplained MSAFP elevations were a MSAFP level 2.0 or greater multiples of the median ( MoM ), a single gestation, a confirmed gestatio- nal age and no fetal malformation or death on ultrasonography. In this study, 991 woman who attended the antenatal clinic at Taejeon Eul Ji Hospital from March, 1996 to March, 1997 were reviewed and data from 79 women with elevated maternal serum alpha-fetoprotein levels were analysed. The 67 of 79 patients with elevated maternal serum alpha-fetoprotein levels had on unexplained elevated MSAFP level. 13 women could not follow up. 54 pregnant women with unexplained elevated MSAFP levels were classified as the index group of singleton pregn- ancy and were matched against a control group. 108 patients with MSAFP levels 0.5 to 2.0 MoM served as control group. The incidence of antepartum hemorrhage ( placental previa ), preterm labor, intrauterine growth retardation ( IUGR ), low birth weight and pregnancy induced hypertension ( PIH ) in two groups was analyzed and the results was subjected to Fisher's Exact Test. None of the patients in the index group had chromosomal abnormalites or birth defect. IUGR occurred in 7 ( 12.96% ) of the index group babies but in only 3 ( 2.78% ) in the control group ( p < 0.02 ). preterm labor occurred in 5 ( 9.26% ) in the index group compared with 2 ( 1.85% ) in the control group ( p < 0.05 ). low birth weight occurred in 3 ( 5.5% ) of the index group babies and in 1 ( 0.9% ) in the control group ( p < 0.1 ). This study suggests that patients with unexplained midtrimester elevations of MSAFP are increased risk for IUGR, preterm labor. But no significance differences were observed in the incidence of low birth weight, antepartum hemorrhage ( placental previa ), PIH.