Also known as the Alpha-Fetoprotein (AFP) test, the Maternal Serum Alpha-Fetoprotein Screening (MSAFPS) is a screening tool that measures the level of alpha-fetoprotein in a pregnant woman’s blood. It’s essential to note that this is not a diagnostic test. Typically, it is part of a triple screening test that helps determine if further diagnostic testing is necessary.
What is a Screening Test?
Understanding what a screening test entails is crucial before undergoing the procedure. This knowledge can help ease any anxiety related to test results. Screening tests don’t solely analyze blood test results; they also evaluate various factors (such as age, ethnicity, and blood test results) to estimate the likelihood of a person having a particular abnormality. These tests do not diagnose problems; they merely indicate the need for further evaluation.
How is the MSAFPS Conducted?
A sample of blood is drawn from the mother’s arm and sent to a lab for analysis. Results are typically available within one to two weeks.
When is the MSAFPS Administered?
The MSAFPS can be performed between the 14th and 22nd weeks of pregnancy, with the most accurate results generally obtained during weeks 16 to 18. Because AFP levels fluctuate during pregnancy, knowing the exact gestational age is critical for reliable outcomes.
All pregnant individuals are encouraged to have the MSAFPS, but it is particularly recommended for:
- Women with a family history of congenital defects
- Women aged 35 or older
- Women who have used potentially harmful medications or substances during pregnancy
- Women with diabetes
What Does the MSAFPS Look For?
Alpha-fetoprotein (AFP) is present in fetal serum and amniotic fluid. This protein is produced early in pregnancy by the yolk sac and, later on, by the fetal liver and gastrointestinal tract. The exact function of AFP is not fully understood. It’s known that AFP levels rise and fall during various weeks of pregnancy, making accurate dating essential for trustworthy results.
The MSAFPS measures both high and low levels of AFP. Results are combined with the mother’s age and ethnicity to assess the risks of potential genetic disorders. Elevated AFP levels may suggest that a fetus has a neural tube defect, such as spina bifida or anencephaly. High AFP can also indicate issues with the esophagus or abdominal wall closure in the baby. However, the most common reason for elevated AFP is inaccurate pregnancy dating.
Low AFP levels, along with abnormal hCG and estriol levels, could indicate that the fetus has trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome), or another chromosomal anomaly. Abnormal levels can also result from:
- A multiple pregnancy
- Pregnancies that are either more advanced or less advanced than expected
What Do the Test Results Mean?
It’s crucial to remember that the AFP test is a screening tool, not a diagnostic one. The results simply indicate whether a mother is at risk of carrying a baby with a potential disorder. There are approximately 25 to 50 abnormal test results for every 1,000 pregnancies tested. Out of these abnormal results, only 1 in 16 to 1 in 33 pregnancies actually result in a baby affected by a neural tube defect or other conditions. The benefit of screening is that 75% to 90% of babies with neural tube defects are detected.
Abnormal test results warrant further testing for diagnosis. A conservative approach may involve conducting a follow-up MSAFPS or a complete triple screening test followed by a high-resolution ultrasound. If abnormal results persist, more invasive procedures like amniocentesis might be recommended.
These invasive procedures should be carefully discussed with your healthcare provider and your partner. Counseling and additional conversations with a social worker or minister can also be beneficial.
What Are the Risks and Side Effects of the MSAFPS for the Mother or Baby?
Aside from the discomfort of blood withdrawal, there are no known risks or side effects associated with the MSAFPS.
What About Further Testing?
The MSAFPS is a routine, non-invasive procedure that poses no known risk to the mother or baby. The results may lead to additional testing. The reasons for pursuing further testing can vary among individuals and couples. Additional testing can help confirm a diagnosis and provide specific opportunities:
- Explore potential medical interventions
- Begin planning for a child with special needs
- Start addressing anticipated lifestyle changes
- Identify support groups and resources
- Decide whether to carry the pregnancy to term
Some individuals or couples may choose not to pursue further testing for various reasons:
- They feel comfortable with the results, regardless of the outcome
- For personal, moral, or religious reasons, deciding on whether to carry the child to term may not be an option
- Some parents may prefer not to be aware of any potential issues
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In summary, the MSAFPS is an important screening tool in prenatal care that assesses the risk of certain genetic disorders. While abnormal results may cause concern, they do not confirm a diagnosis. Instead, they act as a prompt for further testing and discussion with healthcare providers. For those navigating the path to conception, resources and options are available to support your journey.