Value of maternal serum alpha-fetoprotein levels of 5.0 MOM or greater and prenatal sonography in predicting fetal outcome.

Abstract

To determine fetal outcomes and the capability of sonography to help predict these outcomes in patients with maternal serum alpha-fetoprotein (MSAFP) levels of 5.0 multiples of the median or greater. Real-time sonography was performed in patients with singleton and multiple gestations. After sonography, the pregnancy was monitored. Inaccurate historical dating caused elevated MSAFP levels in 14 patients. In the remaining 72 singleton gestations, 42 fetuses (58%) had anomalies, 13 (18%) died in utero or after birth, three (4%) had intrauterine growth retardation or were premature, and 14 (19%) were normal, with no complications. A poor outcome occurred in 58 (80%) of the singleton pregnancies, and sonography depicted an abnormality in 49 (84%) of these patients. Most pregnant patients with MSAFP levels of 5.0 MOM or greater have an unfavorable outcome. Sonography depicts most of these abnormal pregnancies.