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Re: Advice on normal serum AFP, elevated amniotic fluid AFP?From: Braun, R. Daniel (rbraun@iupui.edu)Fri Mar 26 04:28:36 1999
This is indeed a worrisome problem. I have previously had a similar patient. She and I worried for the whole pregnancy(TWICE). The 1st pregnancy, she was 38 and underwent amniocentesis at 14 weeks. The karyotype was nl. And the AFAFP was 3.5 MOMs. The second pregnancy at age 41, the AFAFP was 3.2 MOMs. Both pregnancies were delivered at term of normal healthy babies. All you can do is monitor her very closely looking for all kinds of things and see what happens. As far as I know, there is no real data out there on this situation. Lord knows, I tried to find it. The data that is available relates to an elevated MSAFP being associated with poor pregnancy outcome. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN -----Original Message----- From: annette lee [SMTP:aleeoc@rocketmail.com] Sent: Thursday, March 25, 1999 1:25 PM To: Multiple recipients of list Subject: Advice on normal serum AFP, elevated amniotic fluid AFP? How would you manage a patient with a normal triple screen who underwent genetic amnio at 16 weeks (well dated by LMP and first trimester sono) and was found to have nl 46XY karyotype but AMNIOTIC fluid AFP 2.1 MOM. Amniotic fluid negative for fetal hemaglobin ruling out contamination with fetal blood. Acetylcholinesterase negative and no evidence of renal, neural tube or GI abnormality on level 2 scan? A quick medline search suggests that this is either a false positive, could indicate increased risk of pre-eclampsia or very subtle neural tube defect. The patient is a physician to boot.
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