Abnormally elevated AFP in the serum of a pregnant woman can have one or more of these sources:[citation needed] Usual follow-up steps include (1) a prenatal ultrasound exam to look for fetal abnormalities and/or (2) measurement of AFP in amniotic fluid obtained via amniocentesis.
Maternal serum AFP (MSAFP) varies by orders of magnitude during the course of a normal pregnancy.
Because MSAFP test results must be interpreted according to the gestational age, they often are reported in terms of multiple of the median (MoM).
Patients with abnormal MSAFP need to undergo detailed obstetric ultrasonography.
Genetic counseling usually is offered when the screening test result is positive.
However, because AFP-based screening only has an 80-85% sensitivity for neural tube and abdominal wall defects,[2] many maternal-fetal medicine specialists and some obstetricians do not bother ordering an AFP test and instead perform detailed "Level-II" ultrasounds on all of their patients, which, in competent hands, results in a 97% sensitivity for these defects[citation needed].
AFP is considered a useful marker for post-treatment monitoring of HCC patients (e.g. for treatment efficacy or tumor recurrence).
[12][13] AFP-L3, an isoform of AFP which binds Lens culinaris agglutinin, can be particularly useful in early identification of aggressive tumors associated with HCC.
[16] Increased serum levels in adults are also seen in acute hepatitis, colitis and ataxia telangiectasia.
Increased serum levels of alpha-fetoprotein are sometimes found in citrullinemia and argininosuccinate synthetase deficiency.