Triple test, or "prenatal risk assessment": hCG, AFP and free estriol. The norm and deviation of the AFP analysis during pregnancy Afp which week to take

So, AFP is first of all…

Let's figure it out, AFP, or rather, as doctors call it alpha-fetoprotein, today is a strictly special protein that can be produced by the liver, as well as the gastrointestinal tract of a very small fetus. Moreover, AFP is produced starting from the 5th week of pregnancy - but until that time, it is the corpus luteum of pregnancy that is fully responsible for the synthesis of AFP. The total concentration of alpha-fetoprotein in the blood of the embryo is constantly growing, and throughout the entire period of its intrauterine development - and it is this protein, or rather its presence or absence, that can prevent the immune rejection of the embryo by the body of the expectant mother. Moreover, in parallel with how the concentration of alpha-fetoprotein in the body of the unborn baby will increase, its level will also increase directly in the blood of the future mother, reaching its maximum concentration only by 32 or even 34 weeks.

AFP tests during pregnancy: when is it better to do them and why is it needed?

AFP analyzes during pregnancy are necessary to determine the presence or absence of development of possible chromosomal abnormalities in the fetus, as well as to determine possible pathologies of its internal organs, or defects in the development of the entire nerve canal of the unborn child. The optimal period for conducting a specialized analysis for the concentration of alpha-fetoprotein is considered to be the time interval between the twelfth and twentieth weeks of pregnancy, and the ideal time is the time of the fourteenth or fifteenth week.

What can an AFP test during pregnancy signal to physicians?

According to a special international system of standards, the general designation of deviations from the accepted norm of AFP concentration is usually measured in MoM (more precisely, multiples of median - literally multiples of the median), in fact, which indicates the available average values that correspond to this specific gestational age. It is considered absolutely normal to consider indicators ranging from 0.5 MoM and up to 2.5 MoM. In cases where the concentration levels of AFP deviate somewhat from the accepted norm, more or less, this can clearly indicate some problems in the development of this fetus.

So, for example, with an excess level of AFP concentration during pregnancy, doctors can talk about:

multiple pregnancy.
About the wrong period of pregnancy.
About some malformations of the baby's neural tube.
About a certain pathology of the kidneys of the unborn child.
About liver necrosis.
Perhaps an umbilical hernia in the fetus.
On the possible non-union of the anterior abdominal wall in the fetus.
And about other fetal malformations.

But a reduced level of AFP concentration during pregnancy may indicate:

Delay in fetal development.
About the possible development of Down syndrome.
About the possible development of trisomy 18.
About other chromosomal disorders in the fetus.
About the possible development of hydrocephalus.
About the likelihood of miscarriage, or intrauterine death of the fetus.
About bubble drift.

An unfavorable analysis of the concentration of AFP during pregnancy is not a reason to panic!

According to statistics, about 5% of all pregnant women who take this analysis end up with not entirely favorable results, but at the same time, almost 90% of these pregnant women subsequently had completely healthy babies. It should be taken into account that such an analysis for the concentration of AFP during pregnancy in no case can in itself become a real reason for making a final diagnosis. This analysis is just a kind of marker for a possible risk assessment. And, in addition, an analysis for the concentration of AFP taken during pregnancy by itself cannot have a full and reliable information content. Such an analysis should always be carried out in a complex manner, first of all, in conjunction with, and sometimes also with tests for the level of hCG and the level of free estriol (this is the so-called triple test by doctors).

And how do you understand the need for such tests, and the timing of their conduct without fail, only your doctor will have to establish. To conduct the same tests, blood is taken from a vein - and without fail in the morning and only on an empty stomach. In the event that, nevertheless, for some reason, even a light breakfast took place, no less than 4 hours should pass before such a blood test for analysis. But with an unfavorable result, with some deviations from the accepted norm, your doctor will definitely have to advise you to undergo such an analysis again and will definitely have to refer such a pregnant woman to a more complex and revealing one. In addition, the doctor will have to prescribe amniotic fluid tests. Sometimes you may also need an appropriate consultation with a geneticist.

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

Since, 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. At the same time, the protein takes an active part in the process of formation, including the development of the liver of the embryo, it also helps to 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 performed by the fetus. But still, to date, the available possibilities of AFP have not been fully explored by doctors. Its level rises taking into account the increase in the concentration of this protein observed in the blood of the embryo. Therefore, therefore, the doctor during the bearing of the baby, the AFP rate is carefully monitored.

During the bearing of the baby, AFP analysis helps to investigate the state of the fetus. Whether the correct development of the fetus can be determined already in the second phase of pregnancy. By 32-34 weeks of the process of bearing a baby, the level of alpha-fetoprotein reaches the highest level of saturation, after which it gradually begins to decrease. In a child, by the first year of his life, the level of this substance reaches the norm of indicators, as in an adult.

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

What do AFP rate changes show?

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

However, a lower level of AFP also means no less anxiety. Since back 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 ailment as Down syndrome.

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

At an earlier stage, it is not possible to identify existing violations of the neural tube of the embryo, however, at a later stage of pregnancy, AFP can only establish the degree of maturity of the unborn baby. It is advisable, along with the implementation of AFP, to examine the blood serum of expectant mothers for chorionic gonadotropin.

Reasons for the decrease in AFP levels

A decrease in this substance may mean the following:

death of the embryo;
false pregnancy;
development in the future baby;
cystic skid;
fetal growth retardation.

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

A decrease in AFP levels can be observed in the presence of such changes in the body:

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

If the expectant mother was found to have abnormal AFP levels, it is imperative to undergo a detailed examination. Namely, it is necessary to perform an ultrasound examination, it is necessary to pass repeated tests, in particular, it is necessary to perform. Based on the information received, as well as after an additional examination, the doctor will be able to diagnose the pregnant woman as accurately as possible.

Alpha-fetoprotein is the name of a protein that is produced in the gastrointestinal tract and liver of an unborn child. Its function is to transport nutrients from mother to fetus. By the way, it is this protein that protects the embryo from rejection by the mother's immune system. Throughout the entire period of development of the baby, the concentration of AFP during pregnancy increases both in the blood of the fetus and in the blood of the mother. In the first month of pregnancy, alpha-fetoprotein is produced by the corpus luteum of the ovaries, and from the 5th week and the rest of the pregnancy, this protein is produced by the fetus itself. The highest concentration of AFP in the blood is contained for a period of 32-34 weeks, and after that it begins to slowly decrease.

AFP analysis during pregnancy, as a rule, is taken at 12-14 weeks of the term. This indicator is necessary to determine the anomalies in the development of the baby at the chromosomal level, pathologies in the development of the nervous system, as well as defects in the formation and development of internal organs. Therefore, doctors carefully monitor the concentration of this protein in the blood serum of a pregnant woman.

AFP - the norm during pregnancy

The table below shows AFP levels during pregnancy.

It should be said that the AFP indicator during pregnancy, as well as in non-pregnant women and adult men, may have an acceptable deviation, its value is from 0.5 to 2.5 MoM (multiplicity of the median). The deviation depends on the gestational age, as well as on the conditions of blood sampling.

AFP levels during pregnancy

An elevated AFP level during pregnancy can be an alarm signal, in this case it is necessary to conduct a diagnosis to determine the following fetal diseases:

liver necrosis that occurs after any infectious disease of the mother;
kidney anomaly;
umbilical hernia;
anencephaly;
spina bifida;
malformations of the anterior abdominal wall;
others .

In addition, elevated AFP in pregnant women may occur with multiple pregnancies.

A low AFP during pregnancy can be detected in the following situations:

trisomy 18;
Down syndrome;
delayed fetal development;
hydrocephalus;
imaginary pregnancy;
spontaneous miscarriage;
fetal death.

Sometimes low AFP during pregnancy is a sign of incorrect timing.

AFP and triple test

An AFP blood test during pregnancy gives more reliable indicators if the diagnosis is carried out together with an ultrasound study, determination of the level of free estriol and placental hormones. An analysis for all of the above indicators, as well as for AFP and hCG during pregnancy, is called a “triple test”.

Blood for AFP during pregnancy is usually taken from a vein. The analysis should be taken in the morning on an empty stomach. If, on the date of the test, you nevertheless had a snack or, for example, had breakfast, then at least 4-6 hours must pass after the last meal, otherwise the result will be unreliable.

If AFP analysis during pregnancy showed a deviation from the norm - do not worry ahead of time! First, the doctor will ask you to take the test again to make sure the analysis is accurate. Then he will prescribe an analysis of the amniotic fluid and a more complex and accurate ultrasound. In addition, it will be necessary to consult with a geneticist. Secondly, an unfavorable result of AFP is only an assumption about possible malformations. No one will make such a diagnosis without a lot of additional examinations. In addition, if we take into account the statistics, we can see that only 5% of pregnant women get an unfavorable result, and 90% of them give birth to completely healthy babies.

And - a very important period in a woman's life. You can take care of the health of the child at the very beginning of pregnancy, and modern medicine and technology can provide effective assistance in this. In particular, a variety of things can explore the body of a woman and her baby.

Among them may be a blood test for AFP. In this article, we will try to find out what it is - alpha-fetoprotein during pregnancy, why it is so important and how it is measured.

Properties and significance for the body

AFP is an abbreviation, the decoding of which means "alpha-fetoprotein". AFP analysis during pregnancy is a way to detect and prevent the development of defects.

Alpha-fetoprotein is formed during the development of the embryo and fetus. This protein was discovered in 1944, but scientists have not yet fully understood all of its properties and functions. It is known that alpha-fetoprotein is initially produced by the yellow body of the ovaries of a pregnant woman, and then, from the 5th week, the fetus can already produce it itself.

It is synthesized by the liver and gastrointestinal tract of the embryo; it is a precursor of albumin. Of great importance is the ability of AFP to protect the unborn baby from rejection by the mother's immune system. Also, its function is to transport oxygen to the body of the fetus.

How AFP levels change during pregnancy

At the 5th week of pregnancy, the embryo is already ready to independently begin to produce alpha-fetoprotein, which is necessary so that the mother's immunity does not reject the new organism developing in her. In the process of growth and development of the baby, the level will gradually increase. The embryo releases it into the amniotic fluid in the womb, from where it enters her bloodstream, and then is excreted from her body through the process of natural metabolism.

The concentration of alpha-fetoprotein in the mother's blood, respectively, will increase over time and reach a maximum value of 32-, after which it will begin to decrease. The protein level returns to normal closer to the time when the child is one year old, and becomes the same as in a healthy adult.
The optimal time for diagnosing the level of AFP in the body of a pregnant woman is 12-. The data obtained during this period are the most valuable for the study.

Important! The control of alpha-fetoprotein during pregnancy is very important for the health of the unborn baby. It can reveal fetal pathologies or obstetric mothers. You need to know that AFP levels change every week.

Indications for analysis for alpha-fetoprotein

Arriving at an appointment with an obstetrician-gynecologist, a pregnant woman may be prescribed an analysis to control the concentration of alpha-fetoprotein in the blood, based on her condition and history.

There are a number of medical indications, in the presence of which the doctor may recommend taking an AFP test during pregnancy:

age over 35 years;
spouses are close relatives;
the presence in the anamnesis of one of the spouses or close relatives of genetic diseases, malformations;
the birth of children with malformations and / or diseases that are inherited;
spontaneous and stillbirth;
primary infertility or primary amenorrhea;
taking medications that are prohibited for pregnant women in the I and II trimester, as indicated in the annotation to the medication;
x-ray study.

Procedure for preparing and conducting analysis

Doctors recommend testing for alpha-fetoprotein at 13-15 weeks, because this is the period when the result of the study in pregnant women is most accurate.
To obtain the most informative and reliable analysis result, the procedure for preparing for it should be as follows:

Cancel the intake of medications 1-2 weeks before the planned date of delivery, and if this is not possible, then be sure to inform the doctor at the point of delivery of the analysis, indicating the data on which particular drugs they are and the dosage in which they are taken. Accumulating in the body of a woman, the substances that make up the drugs can affect the result of the examination.
Exclude alcoholic beverages, spicy, salty, fatty and fried foods from the diet of a pregnant woman on the eve of delivery.
Limit physical activity on the body of a pregnant woman, namely carrying weights and active physical exercises for 1-2 days.
The test for alpha-fetoprotein passes strictly on an empty stomach and this is an important condition. The last meal should be at least 8 hours before the analysis. In the morning on the day of blood donation, it is allowed to drink only 100-200 ml.

Analysis during pregnancy: norms and deviations

A blood test for alpha-fetoprotein during pregnancy can be taken from the 12th week to the 30th. During this period, its concentration can give a lot of information about the health of the expectant mother and the process of intrauterine development of the baby.

Since the level of AFP during pregnancy changes every day, there are norms for its concentration by week, which are convenient to consider in the table:
If, as a result of the AFP analysis, a discrepancy between the norms is found, the gynecologist may prescribe additional studies that can give a clearer picture of the health of the woman and the fetus. It is mandatory to carry out in order to accurately determine the gestational age. In the process of performing the study, the doctor can visually confirm the indicators and possible malformations of the embryo.

Important!A deviation from the norms of the level of alpha-fetoprotein in the blood of a pregnant woman can be an important signal for the doctor. Timely identified discrepancies will allow for effective treatment or timely pregnancy.

Additionally, the doctor may refer the patient to the study of placental hormones in order to understand the state of the fetoplacental system. It is also recommended to pass a triple test, which includes an analysis for AFP, hCG and free estriol. The data obtained as a result of the survey will allow us to assess the risk of malformations in the fetus and take the necessary measures to maintain the health of the mother and child.

The norms for the analysis of AFP and hCG during pregnancy are shown in the table:

Physiological norms of content

The physiological norms of the alpha-fetoprotein indicator, obtained as a result of a blood test, range from 10 ng / ml to 8 IU / ml.

Did you know?By the end of the pregnancy, the placenta produces the same amount of estrogen as the gonads of a non-pregnant woman for three whole years.

AFP deviation from the norm is measured in units called MoM, which are standard for all laboratory studies. This is an indicator of the ratio of the real level of alpha-fetoprotein to the median (the average value of the content of alpha-fetoprotein in the blood). The median value is normal if it is between 0.5 MoM and 2.5 MoM.
Deciphering the analysis of AFP during pregnancy will show whether the deviation from the norms and medians is significant. Using the MoM indicator, it is possible to compare the value of analyzes obtained in different laboratories and carried out by different methods. Research can be done using:

immunochemical method;
enzyme immunoassay.

To find out what it says and what a blood test for AFP shows, you should consider the causes of increased and decreased concentrations of alpha-fetoprotein and its effect on the body of a pregnant woman and on the intrauterine development of the fetus.

Increased concentration of AFP

An increase in the level of alpha-fetoprotein in the blood of a pregnant woman means that there may be:

multiple pregnancy;
large fruit;
malformation of the neural tube of the fetus;
fetal liver necrosis;
pathology of the kidneys of the fetus and urinary tract;
umbilical hernia of the fetus;
Shereshevsky-Turner syndrome.

Decreased concentration of AFP

If the concentration of AFP in the body of a pregnant woman is below normal, this may mean:

Down syndrome in the embryo (provided that the study was carried out after the 10th week of pregnancy);
Patau syndrome;
trisomy 18;
intrauterine growth retardation;
fetal death or missed pregnancy;
risk of spontaneous miscarriage.

Summing up, it should be said that the analysis for the level of alpha-fetoprotein is an important medical study that must be submitted within the time specified by the doctor, without fail adhering to the indicated recommendations. Timely examination of a pregnant woman can prevent the risk of developing fetal pathologies and save his life. And only a qualified doctor can do such an analysis, so do not be afraid to contact him for help.

Couples dreaming of children wish them happiness and health. Statistics, unfortunately, give disappointing facts that a certain number of newborn babies have various pathologies that affect the quality of life not only of children, but also of their environment. Such cases are not isolated, and the reasons that lead to such undesirable results during pregnancy are explained by many circumstances. This is the current state of ecology, and the living and working conditions of parents, as well as the rhythm and way of life. The birth of children doomed to torment can be prevented using intrauterine methods for determining deviations and the presence of various pathologies in the development of the fetus.

One of these methods for determining deviations is the examination of alpha-fetoprotein. This analysis is recommended for every pregnant woman who wants to give birth to a healthy and strong baby. The survey is best done in the first trimester, 10, 11 and 12 obstetric weeks are considered optimal. The error of this type of testing is about 5 - 10%, subject to the rules of the survey. However, the reliability of the results still needs to be confirmed, which is carried out with the help of some additional analyzes. Only on the basis of a full and comprehensive examination, it is possible to make a final diagnosis and decide on further actions.

AFP screening analysis is the initial step in the process of diagnosing fetal abnormalities during pregnancy. It is premature to draw conclusions on one survey; a comprehensive, comprehensive examination is necessary.

What is alpha fetoprotein

Alpha-fetoprotein is a special kind of protein that begins to be produced immediately after conception. Initially, the enzyme is produced by the mother's body, in particular, the corpus luteum of the ovaries. Then the formed embryo begins to produce it with the help of the yolk sac of the embryo, and, finally, as the fetus develops, the cells of its liver synthesize the protein.
Alpha-fetoprotein, and in particular, its certain concentration, plays a decisive role in the full development of the child in the womb and performs a number of important tasks. This:

the transfer of the constituent elements of maternal blood, which is performed by transport proteins that are also involved in the construction of the baby's body, ensuring its growth and development;
transportation of polyunsaturated fatty acids, which ensure the production of fetal cell membranes, and before childbirth, literally a month before their resolution, these cells are involved in the production of surfactant (a substance that envelops the alveoli in the lungs), which ensures independent breathing of a newborn child;
blocking the effect of the maternal hormone estrogen on the growing body of the unborn child;
an obstacle to the influence of the immune system of the expectant mother, who is trying to reject the embryo, perceiving it as a foreign body (reduces the formation of a woman's immune cells that affect the developing fetus, which allows it to endure and spontaneously reject).

AFP in the urine of the fetus is excreted in the amniotic fluid, and thus absorbed into the blood of the pregnant woman. Part of the protein enters the mother's circulatory system through the placenta.
In non-pregnant women, this type of protein is formed only when tumors occur. By the way, the same applies to males. The synthesis of this complex biological substance in this case is provoked by the growth of cancer cells in the liver, testicles in men or ovaries in women. The results of the analyzes confirm the presence of such a pathology in approximately 4-5% of such subjects.
During pregnancy, AFP testing helps to monitor the development of the unborn child. Usually a normal pregnancy is confirmed by the results of the examination, which is carried out in the second trimester. At a later date, at about 32 - 34 obstetric weeks, AFP values should normally increase to peak values, while closer to the resolution of childbirth, they should gradually decrease. In a one-year-old child, AFP values do not differ from those of an adult.
By week 12, the child's liver is able to independently synthesize AFP, supplying it to the circulatory system. The study of the mother's blood serum during this period allows you to control the state of intrauterine development of her unborn child.

Indications for analysis

An AFP examination as part of the professional management of pregnancy is prescribed for all expectant mothers. The optimal time for this analysis is the 12th week. The need for repeated tests of this plan is determined entirely by the results of the first examination. If the result of the examination is unsatisfactory initially, this means that the state of health of the pregnant woman requires a more thorough check.

AFP examinations require the following medical indications:

if a married couple who conceived a child is related by blood;
if the pregnant woman already has a child with developmental disabilities or a hereditary pathology;
in late pregnancy, if the expectant mother is over 35 years old;
upon contact with chemicals that have a negative effect on the human body as a whole and the pregnancy process, in particular (poisons, radiation, etc.);
if a pregnant woman has a history of miscarriages, stillborn children and the fact that a couple is being treated for infertility;
when taking medications that are toxic to the child;
if there were hereditary diseases in parents, chromosomal pathologies or gene mutations;
with X-ray exposure of a pregnant woman, which happened at the very beginning of pregnancy.

Procedure for testing for alpha-fetoprotein

For the examination, 10 mm of venous blood is needed. The result of the analysis is the determination of the level of AFP in maternal blood.
To conduct the test, it is important to prepare in a timely and correct manner:

at least 10 days, and preferably two weeks, stop taking any medications (the concentration of drugs that act by accumulating in the body will distort the true AFP content in the blood);
a day before blood sampling for AFP during pregnancy, a woman should consume exclusively dietary food;
for a day or two, it is recommended that a pregnant woman refrain from physical exertion (do not carry weights, wait a little with cleaning, washing and other physical work);
the examination is carried out on an empty stomach, or not less than 5 hours after the last meal. Just before the analysis, you can drink no more than one glass of filtered water, since drinking plenty of water can reduce the level of AFP in a woman's body during pregnancy.

The test is carried out immediately after sleep, preferably with the shortest possible time interval. Therefore, choose a laboratory that is close to your home.

Norm of analysis for AFP

Medical laboratories contain in their arsenal various reagents for conducting tests and use variable research methods. The boundary values, which are often considered the norm, largely depend on the number of complete obstetric weeks and the rate of protein penetration through the placenta into the body of the expectant mother.
The generally accepted systems for measuring the level of AFP are calculated in MoM or U / ml, and are standard values for all laboratories. The normal content for any period of pregnancy is considered to be a level in the range from 0.5 to 2 MoM.
The value of the AFP indicator normally changes by weeks of pregnancy according to the following scheme:

5 - 11 weeks: the upper limit does not exceed 15 U / ml;
13 - 15 weeks: concentration in the range of 15 - 62 U / ml;
15 - 19 weeks: AFP values range from 15 to 95 U / ml;
20 - 25 weeks: the norm is calculated between 28 and 125 U / ml;
25 - 27 weeks: AFP in the range of 50 - 140 U / ml;
28 - 31 weeks: increase to 68 - 150 U / ml;
32 - 34 weeks: the maximum value reaches from 100 to 251 U / ml.

The concentration of AFP in healthy men and women is considered normal if its value does not exceed 10 U / ml.
Future mothers are re-analyzed at 16-18 weeks of pregnancy. The norm for such a period is the AFP limits of 15 - 95 U / ml or 0.5 - 2.0 MoM.
The results of the AFP examination are compared with the indicators of the examination for hCG during pregnancy and the level of estriol at this time.
In the practice of obstetrics, there are often cases when, when examining women in position, deviations are revealed both up and down.

Increased concentration of AFP

Often, the excess of normal values in pregnant women is more common than low concentrations. Any deviation from normal indicators is fraught with the development of anomalies of organs of various levels of severity in a child. Additional tests are needed to confirm the diagnosis.
Only a doctor can confirm developmental abnormalities after a fetal ultrasound procedure. If suspicions remain after the ultrasound, to complete the picture, the level of human chorionic gonadotropin (hCG) in the blood is usually determined and an analysis of amniotic fluid called amniocentesis (amniotic fluid is examined) is performed.
The list of causes that cause elevated AFP during pregnancy:

multiple pregnancy;
a viral infection that was transmitted to the child;
large fruit;
signs of fetal underdevelopment;
the presence of an umbilical hernia in the fetus;
gastroschisis (expressed in nonunion of the abdominal wall);
abnormal development of the kidneys and urinary system of the child (the fetus does not have one or both kidneys, polycystic kidney disease, the incomplete formation of these organs);
pathology of the development of the fetal brain (the neural tube has developmental defects, the absence of the brain or part of it, and other abnormalities);
pathology of the development of the digestive organs (intestine or esophagus with a closed end or shortened, anomalies in the development of the stomach);
hydrocephalus;
cystic skid;
chromosome pathology (signs of Down syndrome, Patau or Edwards syndrome);
development of diabetes mellitus or hypertension in a pregnant woman;
obesity during high pregnancy;
severe form of preeclampsia (late toxicosis);
signs of a threatened miscarriage.

The vast majority of these abnormal changes in the fetus are very severe pathologies leading to the non-viability of the unborn child. Such forms of deviations are caused by an increase in the level of intrauterine protein.
Minor deviations can be ignored, most often they are caused by inaccuracies in determining the number of full obstetric weeks. In such a situation, nothing needs to be done. And with significant differences in indicators from the norms, a clarifying examination of the ultrasound of the fetus and analysis of amniotic fluid should be carried out. When confirming the diagnosis of a pregnant woman, it is recommended to perform an artificial birth.

Decreased concentration of AFP

A decrease in the level of AFP is much less common, such a deviation from normal indicators also indicates an anomaly in the development of the child's body.
Reasons for a decrease in the concentration of AFP:

the threat of miscarriage in the first third of the pregnancy process, and the threat of having a baby prematurely - from 16 weeks;
cystic skid;
the presence of intrauterine anomalies in the development of the fetus;
fading of the fetus (intrauterine);
chromosomal pathologies (Down, Patau or Edwards syndromes).

Fixation of a sharp drop in the concentration of AFP, confirmed by additional examinations, requires urgent intervention and complex treatment aimed at maintaining pregnancy, or a decision on the need for immediate artificial resolution of pregnancy.
An unfavorable AFP analysis is not yet a verdict. Only 5% of women in this case really have serious problems with the development of the child in the womb. Almost 90% of the surveyed expectant mothers subsequently give birth to perfectly healthy children.
An exceptionally unfavorable AFP test result is not sufficient for a definitive diagnosis. It is only a kind of signal that determines the possibility of risk. In this case, it is necessary to consult a specialist who will correctly decipher the test results and decide on further actions.

It is difficult to overestimate the importance of timely examination of AFP by a pregnant woman. The results of the analysis can determine the future fate of pregnancy. Do not expose yourself and your unborn child to the risk of irreparable situations. A timely examination will save your child from an inferior life and can prevent a tragedy in the family. An unfortunate set of circumstances can adversely affect such a pregnancy, but this does not mean that you cannot have completely healthy and full-fledged children.