Question: Recently i did a full health screening while pregnant and my tumour/cancer markers profile (alpha-fetoprotein) is 49.1 (normal reference range is 0 to 10). Is this normal and due to pregnancy?

pregnancyquestionsAnswer: Alpha fetoprotein (or AFP) is a major protein produced by the yolk sac of the fetus, enters the amniotic fluid and crosses the placenta to appear in the mother’s circulation. Pregnancy is associated with raised AFP levels. As you performed the AFP test during pregnancy, the normal reference range of 0 to 10 does not apply to you. A result of 49.1 during pregnancy cannot be interpreted in isolation to decide normalcy. Maternal serum AFP varies by orders of magnitude during the course of a normal pregnancy. It increases rapidly until about 32 weeks gestation, then decreases gradually.

In pregnancy, the AFP result must be interpreted according to the gestational age. The result is reported in terms of multiples of the median (MoM). A typical normal range is 0.5 to 2.0 or 2.5MoM. Raised levels of maternal serum AFP is often seen in a number of fetal abnormalities including neural tube defects. It can also be associated with tumors in the pregnant women or fetus.

A lowered level on the other hand, can be associated with Down syndrome and Trisomy 18. There are also rare tumors in adults that secrete AFP and cause its elevation (liver cancer, endodermal sinus tumors etc), but levels of AFP are often markedly raised in these circumstances.

Maternal serum AFP testing is often carried out together with other blood tests during second trimester of pregnancy to determine the risk of Down syndrome (triple test / maternal serum screening test). If you are concerned about the test result, do speak with your obstetrician to know more about Down syndrome screening during pregnancy.

dr-ben-choeyDr Ben Choey
Obstetrician & Gynaecologist
SBCC Women’s Clinic (Clementi)

Dr Ben Choey is a gynaecologic surgeon who has been committed to women’s health for more than 10 years. He obtained his Master of Medicine (O&G) and became a member of the Royal College of Obstetricians and Gynaecologists (United Kingdom) in 2007.

Dr Ben was appointed Clinical Tutor in Yong Loo Lin School of Medicine and Duke-NUS Graduate Medical School. He aims to provide dedicated obstetrics, gynaecologic and medical aesthetic services to his patients in an environment designed with patients’ comfort and privacy in mind.

sbcc-womens_clinicPractice Address:
SBCC Women’s Clinic (Clementi)
Blk 443
Clementi Ave 3
Singapore 120443

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