This same AFP has a difficult, but quite interesting story of his discovery. Biochemical scientists spent a lot of time and conducted many experiments before they were able to track the “behavior” of this protein in the blood plasma of animals and people. And their attempts were not in vain, because today AFP is used in the treatment of a variety of ailments, including even cancer.

But for pregnant women, its existence can be a kind of trap, despite the fact that the AFP test is perceived positively by many obstetricians.

Alpha fetoprotein during pregnancy: what is it?

So, scientists discovered a specific protein in the blood of mammals (embryonic serum globulin), which, as it turned out later, is formed in embryos (which is why it was assigned the “feto” particle), and in adults is produced during the development of cancer cells and in some other pathologies.

AFP is very similar in structure to the “adult analogue” of SA (serum albumin), and therefore scientists assume that the first protein is a precursor to the second and performs functions similar to it.

Thus, it is believed that thanks to AFP, immunosuppression occurs during pregnancy, that is, suppression of the functions of the immune system, otherwise, in response to the production of specific antigens, the mother’s body would reject the fetus’ body. Fetal immunoglobulin also protects the embryo from the harmful effects of maternal sex hormones (estrogens).

In addition, alpha-fetoprotein is most likely involved in transporting nutrients to the fetus, providing it with vital nutrition. In particular, it binds and transports molecules of polyunsaturated fatty acids through the blood through the placenta, which are not produced in our body, but only come with food, that is, the growing embryo simply has nowhere to get them.

Despite the fact that AFP performs important functions that remain not yet fully understood, its determination during pregnancy acquires special diagnostic significance, allowing one to suspect the risk of developing abnormalities in the fetus. Please note: only suspect that there is a risk, and not diagnose a pathology! We'll talk about this later.

When to get tested for AFP during pregnancy

Alpha-fetoprotein begins to be produced from the first days after conception, and this function is assigned to the corpus luteum. After approximately 5 weeks, the developing embryo takes over this option: AFP is produced in its liver and gastrointestinal tract. But fetal serum globulin begins to enter the maternal blood only from the 10th week of pregnancy.

If a pregnant woman is registered and undergoes all scheduled examinations, then the gynecologist himself monitors the appropriate timing for certain studies. It is believed that it is ideal to take an AFP test during pregnancy at 13-15 weeks (venous blood is taken on an empty stomach).

A woman may refuse this screening. But in some cases, the doctor will stubbornly insist, since there are a number of factors that increase the risk of developing abnormalities in the fetus during gestation. Indications for the test are as follows:

  • The presence of hereditary pathologies in the anamnesis (in previous children or in close relatives of the parents).
  • Habitual miscarriage, stillbirth, miscarriage, or a long period of infertility preceding this pregnancy.
  • First birth at the age of 35 years or more.
  • Blood ties between the parents of the unborn baby.
  • Exposure of a pregnant woman’s body to harmful factors: chemicals, radiation (including taking certain medications and undergoing x-rays in the early stages).
  • Violation of the hemostasis system (in particular, too thick blood).

AFP during pregnancy: normal

Intense production of alpha-fetoprotein by the fetus in the womb leads to the fact that normal levels for women during this period increase slightly. Name specific threshold values ​​(i.e. lower and upper limits normal indicators this marker) is quite difficult, because different laboratories use various methods blood tests and unequal units of measurement. To summarize the data obtained from this analysis and facilitate their interpretation by doctors, a certain universal unit was created - MoM (denoting an average characteristic for a certain period). According to this system, AFP norms during pregnancy should be within the range of 0.5-2.5 MoM.

But in your result, the AFP level may be indicated in other units - pay attention to this. Most often, test systems measure this indicator in international units per milliliter (IU/ml), and each period has its own standards:

AFP by week of pregnancy: table

Once again, we draw your attention to the fact that each individual laboratory has its own standards, and it is with them that the analysis result issued in hand must be compared.

What does an AFP test show during pregnancy: explanation

Within a year after birth, the child’s AFP level normalizes, gradually approaching the normal level in adults (10-15 IU/ml).

So, the most important thing: why determine the level of AFP in pregnant women and what does it promise for those who had low or elevated levels?

Disruption of normal fetal development can be reflected in changes in the normal values ​​of this marker. For example, with open neural tube defects, embryonic plasma enters amniotic fluid(and then into the mother’s blood) in a larger volume, as a result of which the analysis shows an increased level of this protein.

High AFP during pregnancy may also indicate the presence of other pathologies in the fetus:

  • Developmental defects internal organs: neural tube (spina bifida, anencephaly), gastrointestinal tract or genitourinary system.
  • Liver necrosis (usually a consequence of a viral infection).
  • Shereshevsky-Turner syndrome (chromosomal abnormality with a whole range of manifestations).
  • Nonunion of the anterior abdominal wall.
  • Umbilical hernia.

If the test result shows that alpha-fetoprotein is low, then obstetricians will suspect the likelihood of the following pathologies:

  • Fetoplacental insufficiency.
  • Threat of miscarriage or fetal death.
  • Delay in fetal development.
  • Chromosomal abnormalities in the fetus (Down syndrome, Patau syndrome, Edwards syndrome).
  • Bubble drift.

All this sounds scary and gloomy, but the danger actually lies not so much in the results as in their incorrect interpretation. And such mistakes happen all the time. According to data available on the Internet, approximately 5% of the women studied have abnormalities in AFP. But more than 90% of them give birth to healthy children and have no pathologies during pregnancy. Practice proves that the percentage of false positive results is too high!

Meanwhile, alpha-fetoprotein above or below normal may indicate the presence of obstetric pathologies, which is not always as sad as it may seem, but often, nevertheless, quite serious. Increasingly, increased or decreased levels of AFP during pregnancy are not so dangerous, and sometimes not at all dangerous. Such reasons may include:

  • Incorrectly determined gestational age.
  • Features of the menstrual cycle in a pregnant woman (too long or short, irregular, etc.).
  • Carrying twins or a large fetus.
  • Other features of the body condition of a pregnant woman (including overweight, age over 35 years, presence of gynecological diseases, diabetes mellitus, gestosis, unfavorable history of previous pregnancies, etc.).

To summarize, we would like to urge you not to try to decipher the AFP test during pregnancy on your own. Firstly, not even every doctor can do this correctly (always remember this!). Secondly, conclusions are never drawn only on the basis of the indicators of this marker: other indicators are also assessed (in particular the level of hCG, placental hormones, ultrasound data, etc.) and additional studies are required.

And although I don’t want to end the conversation on such a pessimistic note, it’s also impossible not to say this: if a woman is sent for an abortion based on the results of such an analysis (suspecting terrible developmental anomalies in the fetus), then she needs to calm down and think everything over carefully. You should not be too lazy to search the Internet for statistics on how often in such cases women get rid of completely healthy children. And also how expensive 1 gram of alpha-fetoprotein, extracted from the blood of aborted children, is on the pharmaceutical market. And draw the right conclusions.

You should not assume that a deviation from the norm of AFP during pregnancy necessarily carries a danger. And in general, “advanced” medical scientists believe that it is almost impossible to establish this very norm in this case, and that even a set of detectable markers is not conclusive (that is, it does not prove the presence or absence of pathologies). Therefore, they are confident that this screening cannot be carried out during pregnancy: there may be more harm than good.

But in our obstetrics, such diagnostics are considered very important, if not necessary.

Don't worry about anything!

Especially for - Ekaterina Vlasenko

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Alpha fetoprotein or AFP- a protein specific to pregnancy, the study is used to diagnose congenital diseases in the fetus.

Read about alpha-fetoprotein as a tumor marker at the link.

Synonyms: α1-fetoprotein, α-fetoprotein, alpha-fetoprotein, α1-fetoprotein, α-fetoprotein, AFP.

Alpha fetoprotein or AFP is

a glycoprotein synthesized by the yolk sac, gastrointestinal tract and fetal liver. It is excreted by the kidneys into the amniotic fluid from where it drops into the maternal blood, where its concentration constantly increases from 10 to 32 weeks of pregnancy.

The onset of alpha-fetoprotein synthesis coincides with the appearance of hematopoiesis in the yolk sac at 4 weeks of gestation. The function of AFP is transport, similar to albumin in an adult.

The maximum AFP in the blood of a pregnant woman is at the 13th week of pregnancy (about 3 mg/ml), when its synthesis occurs entirely in the fetal liver. The concentration gradually decreases by 0.08 mg/ml until the time of birth. Until the end of the first year of life, the child’s AFP decreases to the adult level.

Alpha-fetoprotein level determination carried out in second trimester(15-20 weeks of pregnancy) in all pregnant women in prenatal screening (triple test). The purpose of the analysis is to identify the risk of congenital malformations and chromosomal abnormalities in the fetus.

As pregnancy progresses, the level of alpha-fetoprotein in the amniotic fluid decreases, and in the mother's blood it increases.

Features of a blood test for AFP

The level of AFP in the blood does not depend on the circadian rhythm. Blood for analysis must be donated in the morning - at 7-9 am, be sure to protect your heart - it is forbidden to eat for 10-12 hours before the analysis, only drink non-carbonated water. Smoking and drinking alcohol is prohibited! Blood for analysis is taken from the ulnar vein.

Be sure to tell your doctor and laboratory if you have kidney or liver disease.

All tests at biochemical screening in the first and second trimesters they are carried out in the same laboratory.

Second trimester screening includes:

  • beta-hCG
  • AFP
  • free estriol

A blood test for alpha-fetoprotein during pregnancy is prescribed

To all women at 15-20 weeks of pregnancy, regardless of age, obstetric and gynecological history, previous diseases and the presence of relatives with chromosomal abnormalities!

Normal alpha-fetoprotein level in blood during pregnancy, mg/l

n.b. - week of pregnancy

  • 5 n.b. 0.35–1.75
  • 6 n.b.0.38 – 1.88
  • 7 n.b.0.45 – 2.25
  • 8 n.b.0.94 - 4.68
  • 9 n.b.1.43 - 7.13
  • 10 n.b. 2.19 - 10.96
  • 11 n.b.2.21 - 11.05
  • 12 n.b.2.9 - 14.52
  • 13 n.b.4.0 - 20.0
  • 14 n.b.5.50 - 27.5
  • 15 n.b.12.23 - 61.15
  • 16 n.b.12.93 – 64.63
  • 17 n.b.14.55 – 72.75
  • 18 n.b. 17.67 – 88.37
  • 19 n.b.19.5 – 97.5
  • 20 n.b.22.0 – 100.0
  • 21 n.b.24.0 – 120.0
  • 22 n.b. 27.0 – 135.0
  • 23 n.b. 30.0 – 150.0
  • 24 n.b. 32.5 – 162.50
  • 25 n.b. 35.0 - 175.0

Norm of alpha-fetoprotein in amniotic fluid, mg/l

  • 15 n.b.3.0 – 40.0
  • 16 n.b.3.2 – 33.4
  • 17 n.b.2.7 – 27.6
  • 18 n.b.2.2 – 21.8
  • 19 n.b.1.6 – 16.0
  • 20 n.b.1.0 – 10.0

Normal level of alpha-fetoprotein in the blood during pregnancy is not defined by international standards, therefore it depends on the methodology and reagents used in the laboratory. In the laboratory test form, the norm is written in the column - reference values.

AFP norm during pregnancy, MoM

  • 0.5-2.0 MoM - is the same for all laboratories

AFP analysis is carried out together with the following studies

  • general blood test
  • general urine test
  • biochemical blood test - liver tests (bilirubin, AST, ALT, GGT, alkaline phosphatase), kidney tests (creatinine, urea, uric acid)
  • glucose
  • total protein
  • human chorionic gonadotropin
  • free estriol

5 facts about alpha-fetoprotein

  • molecular weight 65,000-70,000 Yes
  • half-life 120 hours (5 days)
  • AFP consists of 96% amino acids and 4% carbohydrates
  • Since the 70s, AFP analysis in amniotic fluid has been used to diagnose congenital malformations
  • for alcoholism alpha-fetoprotein levels are elevated

Causes of low levels of alpha-fetoprotein in the blood

- in the fetus

  • Down syndrome
  • Edwards syndrome
  • intrauterine growth restriction
  • fetal malnutrition
  • fetal death

- in a woman

  • hydatidiform mole
  • false pregnancy
  • premature birth
  • spontaneous abortion
  • gestosis - increased blood pressure, edema, protein in urine

Causes of elevated levels of alpha-fetoprotein in the blood

- in the fetus

  • defeat fetal liver- hepatitis and necrosis due to viral disease
  • umbilical hernia and other defects of the anterior abdominal wall
  • Shereshevsky-Turner syndrome- presence of only one X chromosome
  • pathology of the neural tube - anencephaly (absence of the brain) or spina bifida
  • multiple pregnancy - twins or triplets
  • older age of the fetus - discrepancy with the expected age on ultrasound
  • after removal of one fertilized egg during multiple pregnancy with IVF
  • missing twin syndrome
  • triploidy - an extra set of chromosomes in the fetus
  • congenital nephrotic syndrome
  • Potter syndrome- severe congenital kidney disease, extremely low amount of amniotic fluid, facial deformity
  • obstruction of the urinary tract in the fetus
  • obstruction of the esophagus or small intestine
  • hydrocephalus
  • umbilical cord hemangioma
  • umbilical cord hernia
  • tetralogy of Fallot- severe combined heart disease
  • osteogenesis imperfecta

- at the mother's

  • threat of abortion
  • placet pathology
  • uterine bleeding
  • placental abruption

Deciphering the result of a blood test for alpha-fetoprotein

The results of the alpha-fetoprotein blood test should be assessed by a geneticist along with other prenatal screening indicators. Positive screening results are not a diagnosis, they are an indicator of increased risk!

If alpha fetoprotein is outside the normal range and there is a risk of congenital pathology in the fetus - amniocentesis or cordocentesis or placentocentesis is performed. Only on the basis of all examination data can one assert the presence/absence of pathology in the fetus.

The technological capabilities of modern medicine have increased significantly compared to the recent past. Modern equipment, methods and methods of analysis make it possible to clearly monitor the clinical picture of the health status of a pregnant woman, the development of gestation (pregnancy), and the well-being of the fetus.

An AFP test during pregnancy is not always necessary; it is usually prescribed in cases where doctors need a more complete clinical picture of the course of pregnancy. But in some cases, this type of analysis must be done without fail, which we will discuss below.

What is AFP and why do you need to know its level in the blood during pregnancy?

The happy time of pregnancy in the life of every woman is filled with a wide variety of feelings and concerns. There are a lot of worries - you need to constantly monitor your health, change your lifestyle and rhythm of life, because the future fate of the woman, her family and the unborn child depends on this. The only way to successfully overcome this path is to listen to the advice and recommendations of your doctor, follow all his instructions and get tested on time.

AFP is an abbreviation for α-fetoprotein (alphafetoprotein), a type of bipartite (consists of a polypeptide “strand” and a polysaccharide) glycoprotein proteins. Despite the complexity of its structure, this protein belongs to the so-called “protoproteins” - ancient organic formations, whose existence is estimated at millions of years.

AFP functions

This type of protein begins to be synthesized in the female body in the first weeks of gestation. It is produced yellow body(part of the follicular apparatus of the ovaries) and carries out the transfer function, ensuring the transport of polyunsaturated fatty acids from the blood of a pregnant woman to the blood of the fetus, where the latter perform nutritional and construction roles.

At normal conditions, in the absence of gestation or liver cancer, the body does not produce AFP. The transport function is performed by proteins close to α-fetoproteins - albumins, more specifically - serum albumin (SA). It makes up the membranes of red blood cells, and thanks to it, red blood cells are able to carry useful substances in the body.

The difference between AFP and SA is that cell membranes built from AFP have a more strict osmotic function, that is, membrane permeability is stricter than that of erythrocytes, more selective, focused on specific chemicals. Why is this needed? Exact answer medical science can't give yet. The most likely idea remains that this mechanism is directly related to the protection of the fetus from the immune system. Moreover, this protection works on both sides of the biological barrier: AFP protects the fetus both from its own immunity and from the mother’s immunity.

Why is knowing AFP levels useful during gestation?

During gestation, a woman's AFP level is checked for compliance with standards regarding the duration of pregnancy and information obtained using other research methods ( ultrasound diagnostics, amniocentesis). If α-fetoprotein values ​​are decreased or increased, this will be evidence of possible pathologies in fetal development.

AFP analysis

The famous medical scientist, researcher Yu. Tatarinov, studying oncological lesions of the liver, discovered that AFP is a good determinant (marker) of liver cancer - primary hepatocellular carcinoma. Together with his colleagues, the professor developed a method for testing the level of AFP, which was later called the “Tatarinov-Abelev reaction.”

Since α-fetoprotein is closely associated with the gestation process, effective determination of its level has become successfully used in the diagnosis of pathologies associated with fetal development. Today, the AFP test is combined with an analysis of the level of estriol (an estrogen steroid produced by the ovaries) and hCG (human chorionic gonadotropin). This triple analysis is called “triple screening” (from the English screening - “selection”).

Procedurally, AFP analysis is performed by collecting blood from a vein (5-10 ml.).

Indications for AFP testing in pregnant women

  • Pregnancy arose as a result of an incestuous relationship, a marriage between close relatives.
  • The family (mother, father, their parents, their parents' parents, as well as close relatives of their parents) had hereditary diseases (Shereshevsky-Turner syndrome, Down syndrome, Edwards syndrome, polysomies on the X and Y chromosomes).
  • The family has already had children with genetic disorders.
  • The mother, father of the child or their parents practiced a lifestyle that could affect the development of pathologies in the embryo at the genetic level (alcoholism, drug addiction).
  • One or both parents suffered from radiation sickness in the past, lived near nuclear power plants, and were often exposed to X-rays (more than 6 times a year).
  • Pathological changes in brain tissue and organs of the endocrine system of the fetus.
  • Suspicion of a perinatal anomaly, for example, multiple births.
  • Late birth (after 35 years).

Preparing for analysis

Many people, unfortunately, do not understand the importance of preparation for the analysis procedure, and it is important, since the accuracy of the readings is a serious help for the attending physician in determining the true condition of a pregnant woman. Let's say, before the analysis you need to follow a simple diet for several days - do not eat fried, spicy, salty foods, do not drink alcohol - but the patient ignores this prohibition. Why the analysis result will be blurred and unreliable.

To avoid such situations, research medicine urges you to follow the following recommendations:

  • follow a simple diet for 3-7 days before the procedure;
  • do not use medications and nutritional supplements 2-3 days before the procedure;
  • do not smoke for 12 hours before the procedure;
  • avoid physical activity, lifting weights, running over a distance of more than 20 meters, intense physical exercise;
  • before the analysis, do not eat anything for 7 hours (you can drink some water or unsweetened tea);
  • If you have an allergy, you must definitely avoid contact with the allergen on the eve of the test.

An AFP test prescribed once will be prescribed several more times during pregnancy.

To ensure that the results coincide and there are no laboratory distortions, experts advise visiting the same research station, laboratory, or complex.

Normal indicators and pathological deviations in AFP values

Deviation from the norm of AFP is a signal indicating to the specialist about possible disturbances in the development of the fetus. More details about AFP standards in the table:

Table with AFP norms during pregnancy

If the AFP norm is exceeded during pregnancy, this may indicate the following anomalies:

  • Anencephaly.
  • The fruit is large, its weight is 1.5-2 times higher than normal.
  • Hydrocephalus (water on the brain).
  • A woman carries more than one fetus.
  • The fetus has a cleft of the anterior abdominal wall and a hernia of the umbilical cord.
  • The onset of pregnancy has been incorrectly determined.
  • The fetus has kidney and liver failure.
  • Chromosomal abnormalities.

If during pregnancy the analysis shows a low level of AFP, then the following pathologies are possible:

  • Delay in fetal development.
  • Frozen pregnancy syndrome.
  • Incorrectly determined gestation.
  • Hydatidiform mole (this phenomenon is observed in cases of conception of a damaged egg, healthy development of the embryo does not occur, the chorionic villi swell and begin to resemble dew bubbles - hence the name of the pathology).
  • The expectant mother has acute diabetes.
  • Threat of spontaneous abortion (miscarriage).
  • Chromosomal diseases (Down syndrome, Shereshevsky-Turner syndrome, Potau syndrome).

There are a huge number of prenatal tests and tests. They allow you to understand even before the baby’s birth whether his general condition is normal, whether there are any developmental anomalies, and how the pregnancy generally proceeds. One of these markers is the level indicator AFP - alpha fetoprotein. What kind of indicator is this and what does it mean?

AFP: general data and information content of the test:

Alpha fetoprotein (AFP) is a special protein that basically prevents immune rejection from developing in a woman’s body against a new living being born inside her. At the beginning of pregnancy, this substance is produced by the corpus luteum in the female ovaries, and, starting from the 2nd month of pregnancy, it is already formed in the gastrointestinal tract and liver of the fetus. All fluctuations in the level of AFP in a child’s body are directly proportional to its amount in the body expectant mother(absorbed from amniotic fluid). That is, if the protein increases in the fetus, it increases in the blood of the pregnant woman, and vice versa.

By the period of 12-16 weeks of pregnancy, the level of alpha-fetoprotein is considered the most optimal for its determination, in order to obtain information whether the pregnancy is proceeding normally and whether there are any abnormalities in the development of the fetus.

Functions of AFP during intrauterine fetus:

Ensures growth and development through the transport of important building proteins from the pregnant woman’s body to the baby;

Transports polyunsaturated fatty acids throughout the child's body, necessary for the proper formation of cell membranes (membranes) as they grow, and just before birth - for the secretion of surfactant (a substance that covers the pulmonary alveoli from the inside and allows a person to breathe after birth);

Prevents estrogens (female sex hormones) from influencing the developing child’s body;

Holds on normal level blood pressure in the fetal vessels;

It prevents miscarriages by suppressing the immune system, preventing the woman’s body from rejecting the fetus developing inside her.

Performing such a number of useful and important functions, any fluctuation in the direction of increasing or decreasing the level of AFP will indicate deviations in the process of fetal development and the formation of its organs and systems.

Normally, alpha-fetoprotein should be within the following parameters:

Indications for the test and nuances of the test:

A planned analysis to determine the level of AFP is recommended to be carried out during the period of 11-12 weeks (maximum up to 15 weeks). If deviations are detected, another additional study is mandatory. Unscheduled AFP levels are determined according to strict indications.

Conditions for strict indications for AFP testing:

The first birth in a woman over 35 years of age;
- presence of potential parents spontaneous miscarriages or stillborn children;
- the baby was conceived from a consanguineously related couple;
- if the child from a previous pregnancy had genetic pathologies or developmental defects that are inherited;
- if the pregnant woman was (or is) exposed to unfavorable environmental conditions (toxic fumes or radiation);
- the presence of genetic diseases or mutations in the health of any of the future parents;
- taking medications or carrying out forced medical therapy with drugs that have a toxic effect on the unborn child;
- X-ray examinations at the beginning of pregnancy, when the formation of the entire fetal body is underway.

To carry out the analysis, 10 ml of venous blood from a pregnant woman taken on an empty stomach is required. To minimize the risks of errors in results, the following conditions must be met before submitting potential laboratory material:

Do not take any for at least 2 weeks medicines, which can distort test results by accumulating in the bloodstream and affecting the protein;
- before taking the test in the evening, you can only eat until 21:00;
- exclude any physical exertion on the expectant mother’s body a day or two before the test (this includes major cleaning, lifting heavy objects, washing floors, etc.);
- exclude alcohol, as well as spicy, fatty and highly seasoned foods (including salt) the day before going to the laboratory;
- in the morning before going to donate blood, you are only allowed to drink up to 200 ml of ordinary table water (if you eat or drink more, the concentration of true AFP will fall, and proteins from food will give an error for a possible increase in protein, i.e. the information content of the analysis will drop to almost zero) ;
- it is advisable to choose a laboratory as close as possible to the pregnant woman’s home, because blood must be donated within the first hours after waking up.

AFP decrease below normal:

A deficiency of alpha-fetoprotein is observed many times less often than its excess. However, this also indicates some pathologies.

Reasons for decreased AFP concentration:

IUGR (intrauterine growth retardation);
- hydatidiform mole;
- frozen pregnancy;
- threat premature birth, starting from 16 weeks of pregnancy, or miscarriage - up to 16 weeks;
- chromosomal pathologies (Down syndrome, Edwards syndrome, Patau syndrome).

If a lack of AFP is detected, comparing it with the duration of pregnancy, you can begin to take measures to accelerate the development of the fetus and save the pregnant state. But this is only when additional studies (ultrasound, determination of hCG levels, amniocentesis, etc.) did not show a lack of fetal viability.

When an elevated AFP level is observed:

Most often, deviations are observed in the direction of overestimation of protein levels.

The main reasons for increasing AFP levels:

Viral damage to the fetal liver after any viral infection mothers;
- umbilical hernia of a child;
- true fetal obesity;
- multiple pregnancy;
- IUGR;
- abnormalities in organ formation nervous system(absence of the spinal cord or brain, incorrect formation of the spine, etc.);
- gastroschisis (non-union of the abdominal wall);
- hydrocephalus (water on the brain);
- chromosomal abnormalities (Edwards, Atau, Down syndrome);
- anomalies in the formation of the urinary system (underdevelopment or complete absence of kidneys);
- hydatidiform mole;
- anomalies in the formation of the gastrointestinal tract (pathologies in the structure of the stomach or intestinal loops, overgrowth of the intestine or esophageal tube, abnormal length of the intestine towards shortening, etc.);
- threats of miscarriage;
- severe toxicosis during pregnancy;
- increased blood pressure in a woman;
- excessive weight gain during pregnancy or obesity;
- diabetes mellitus.

If there is a slight increase, no measures are taken other than rechecking and recalculating the gestational age. A serious increase in alpha-fetoprotein levels usually indicates critical abnormalities in the development of the fetus, when the topic of its non-viability is raised. Additional studies are prescribed (determination of hCG levels, amniocentesis, ultrasound) and the question of termination of pregnancy is raised.

What to do if deviations from the norm are detected?:

Any deviations in the level of alpha-fetoprotein in the blood of a pregnant woman are not a death sentence or a strict reason for terminating the pregnancy. AFP analysis is only a marker indicating possible deviations in the health of the pregnant woman and the fetus.

According to statistics, 5% of pregnant women received negative results, and 90% of this minimum still gave birth to healthy children. The last word always belongs to additional research methods ( hCG level, amniocentesis, ultrasound, etc.), according to which the picture of the development of the unborn baby becomes more informative. The main thing is to never give up on planned research.


Many people hear about such a concept as AFP, but not everyone understands its essence. This name refers to the protein alpha-fetoprotein and its production occurs in the gastrointestinal tract, in particular the liver of the unborn baby. Regarding its physicochemical properties, AFP, like serum albumin, is an important substance during pregnancy.

Because, first of all, it has a protective function for the fetus, ensuring safety from possible rejection, performed at the immune level, which is produced by the body of a pregnant woman. In this case, the protein takes active participation during the formation process, including the development of the embryo's liver, it also helps maintain the osmotic pressure of the blood of the unborn baby.

At the initial stage, the production of fetoprotein is carried out by the corpus luteum of the appendages, however, in the second month of pregnancy, the production of this substance is already carried out by the fetus. But still, at the moment, doctors have not fully explored the available possibilities of AFP. Its level increases taking into account the increase in the concentration of this protein observed in the blood of the embryo. Therefore, doctors carefully monitor the AFP level during pregnancy.

During pregnancy, AFP analysis helps to examine the condition of the fetus. Whether the fetus is developing correctly can be determined already in the second phase of pregnancy. By 32-34 weeks of pregnancy, the level of alpha-fetoprotein reaches its highest level of saturation, after which it gradually begins to decrease. In a child's first year of life, the level of this substance reaches the normal level of an adult.

In the liver, by the end of the first phase, protein synthesis occurs, and it is from this organ that this substance penetrates directly into the circulatory system. Thus, by examining the serum of the expectant mother, doctors are provided with reliable information about the condition of the unborn baby.

What do indicators of changes in AFP norm show?

Many expectant mothers know that if an increase in AFP occurs during pregnancy, this may indicate that the fetus may have various neural tube defects. In addition, it is noted that an increased level of this protein is a sign of congenital neuroses, and the anterior abdominal wall may have certain pathologies that can cause serious abnormalities in the fetus.

However, a reduced level of AFP also means no less anxiety. Since even in the last century, experts noted that a decrease in this protein is associated with severe disorders, for example, with the occurrence of such an illness as Down syndrome.

At what stage of pregnancy should such a study be performed?

For more early stage It is not possible to identify existing disorders of the neural tube of the embryo, but more later pregnancy, AFP can only determine the degree of maturity of the unborn baby. It is advisable, along with performing AFP, to examine the blood serum of expectant mothers for human chorionic gonadotropin.

Reasons for decreasing AFP levels

A decrease in this substance can mean the following:

  • embryo death;
  • false pregnancy;
  • development of the future baby;
  • hydatidiform mole;
  • delayed fetal development.

When it is noted that the AFP level is slightly reduced, perhaps this also indicates an incorrect determination of the gestational age.

A decrease in AFP levels can be observed if the following changes are present in the body:

  • deterioration of condition women's health;
  • liver necrosis;
  • multiple pregnancy;
  • umbilical hernia;
  • disturbances in the functioning of the neural tube;
  • non-union of the anterior abdominal wall;
  • spina bifida;
  • a pathology that occurs during the formation of kidneys in an embryo.

If you expectant mother abnormalities in the level of AFP have been detected, a detailed examination should be performed. Namely, it is necessary to perform an ultrasound examination, repeat tests should be taken, in particular, it is necessary to perform. Based on the information received, as well as after additional examination, the doctor will be able to make the most accurate diagnosis for the pregnant woman.