abnormal serum screening in pregnancy

Question 1

MCC of abnormal serum screening?

Answer 1

wrong dates and multiple gestations

Question 2

elevated materal serum alpha fetalprotein (msAFP)

Answer 2

associated with an open neural tube defect

Question 3

low msAFP associated with which disorder?

Answer 3

fetal Down syndrome

Question 4

what is alpha fetal protien

Answer 4

protein made by fetal liver - analgoous to adult albumin

Question 5

first trimester screening

Answer 5

use of biochemical markers (PAPP-A and beta hCG) and or transvaginal sonography measuring the aspect of the posterior neck called the “nuchal translucency” giving a risk of Down syndrome and trisome 18.

perfomred btw **10-13 weeks gestation **

Question 6

trisomy screen

Answer 6

done btw 15-21weeks gestation. a common combination that includes maternal serum alpha-fetoprotein, hCG, inhibin-A, and unconjugated estriol

Question 7

what do levels of alpha fetal protein >2.0-2.5 MOM indicate?

Answer 7

suspicious for neurtal tube defects. need further investigation.

Question 8

what are some causes of an elevtaed msAFP?

Answer 8

**1. underestimation of gestational age **

**2. multiple gestations **

**3. neural tube defects **

4. abdominal wall defects
5. cystic hygroma
6. fetal skin defects
7. sacroccygeal teratoma
8. decreased maternal weight
9. oligohydramnios

Question 9

what are some causes of low msAFP?

Answer 9

overestimation of gestational age

chromosomal trisomies

molar pregnancy

fetal death

increased maternal weight

Question 10

pregnancies with elevated _________ after evaluation are unexplained, are at increased risk for stillbirth, growth restriction, preeclampsia, placental abruption

Answer 10

elevated msAFP

Question 11

_______ is asccoicated with fetal exposure to ACE inhibitors

Answer 11

oligohydramnios