High levels of maternal serum alpha-fetoprotein seen in all of the following, EXCEPT.
Alpha-fetoprotein (AFP) is a glycoprotein synthesized by the fetal yolk sac and later by the fetal gastrointestinal tract and liver. It is the major serum protein in the embryo and fetus and is thus analogous to albumin. As shown in Figure its concentration increases steadily in both fetal serum and amnionic fluid until 13 weeks' gestation, after which, levels rapidly decline. Conversely, AFP is found in steadily increasing quantities in maternal serum after 12 weeks. The normal concentration gradient between fetal plasma and maternal serum is 50,000:1 Note the units are different in each of the values shown. This is just to demonstrate how much the levels of AFP vary in the 3 mediums. The scale refers to the fetal plasma level, which is approximately 150 times greater than the amnionic fluid concentration and 50,000 times greater than the maternal serum concentration Elevated Levels Underestimated gestational age Multifetal gestations Neural-tube defect Gastroschisis Omphalocele Cystic hygroma Esophageal or intestinal obstruction SS Liver necrosis Renal anomalies--polycystic kidneys, renal agenesis, congenital nephrosis, urinary tract obstruction Cloacal exstrophy Osteogenesis imperfecta Sacrococcygeal teratoma Congenital skin abnormality Pilonidal cyst Chorioangioma of placenta Placental abruption Oligohydramnios Preeclampsia Fetal-growth restriction Maternal hepatoma or teratoma Low Levels Obesity Diabetes mellitus Trisomies 21 or 18 Gestational trophoblastic disease Fetal death Overestimated gestational age Fetal Death is mostly associated with Low levels of AFP.
Cardiac anomaly
Skeletal deformity
Trisomy 21
Neural tube defect
Prenatal Diagnosis